Childhood scoliosis: the latest advances in surgery

Characteristics, symptoms, screening… scoliosis in 7 questions

1. What are the characteristics of scoliosis?

“When we look at the anatomy of the back, the vertebrae are not aligned in a straight line but they are on a curvature. Its essential clinical sign is “gibbosity”, that is to say a bump next to vertebrae at the top of the spine (we then speak of “thoracic scoliosis”) or the bottom (“lumbar scoliosis”)”, explains Dr Federico Solla.

2. Why are girls mostly affected?

Because growth is faster in girls. They are particularly affected during puberty; this is indeed the period during which the spine will grow several centimeters per year. Scoliosis, which might not be detected before, is then fully revealed.

3. What are the causes?

In 80% of cases, it is an idiopathic scoliosis, that is to say without a specific cause. It appears from childhood and evolves until the end of growth. “Nevertheless, recent work shows that genetic factors might play a role. Another line of research suggests there may be a link to early childhood infections such as encephalitis (1). The child had a fever for 4 or 5 days and recovered very well, but this episode might have had repercussions favoring scoliosis.
More rarely, scoliosis can be “secondary” to a neuromuscular disease (myopathy for example) or bone disease (particularly affecting the vertebrae).

4. Is the idea that posture, heavy school bag or asymmetrical sport leads to scoliosis therefore false?

“Yes, scoliosis is a real deformity that should not be confused with the “scoliotic attitude” which corresponds to the child who holds himself badly. On the other hand, an established scoliosis can be aggravated by bad habits.

5. What are the symptoms?

In the vast majority of cases, scoliosis does not cause symptoms. On the other hand, there may be mechanical pain related to a particular position.

6. If there is no pain, how to detect scoliosis?

Very often, screening is carried out during the annual examination with the pediatrician or at the time of an examination carried out by a school nurse. “The examination of the back will consist of leaning the patient forward, hands joined, head down and legs stretched out to see if there is any asymmetry. The doctor will look at the back of the back to look for a hump. »

7. What consequences?

For the teenager, the impact is mainly aesthetic. This can create embarrassment or even shame when the scoliosis is very pronounced. On the other hand, in adulthood, scoliosis that exceeds a certain threshold (curvature between 40 and 50 degrees) – and which has not been treated – can have complications and lead to osteoarthritis or even pain in the back and legs.

Often these adults have to be operated on. “However, surgery performed in adulthood has ten times the risk of complications than during adolescence. This is why early detection and treatment are essential. »

1. It is an inflammation of the brain usually caused by a virus.

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