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Made up of many individual bones called vertebrae, the spine is joined together by muscles and ligaments. Flat, soft discs separate and cushion each vertebra from the next. Because the vertebrae are separate, the spine is flexible and can bend. Together, the vertebrae, discs, muscles and ligaments make up the vertebral column or spine.
The spine is divided into three regions. The cervical spine refers to the neck, the thoracic spine to the chest and the lumbar and sacral spines to the lower back.
Just as the shapes of peoples’ bodies differ, the normal spine varies in size and shape. No spine is perfectly straight. A healthy spine has front-to-back curves. It is only when these curves become too large that they present a potential problem.
Spinal abnormalities are more common than you think. Many people are affected with some type of spine abnormality, and may not even be aware or need treatment.
Abnormal spinal curves can be the result of many different causes. Some children or adolescents may have a nerve or muscle disease (neuromuscular), injury or other illness that may have attributed to their spinal abnormality. Examples of neuromuscular injuries or illnesses include cerebral palsy, spina bifida and muscular dystrophy.
Some people are born with spinal defects that cause the spine to grow unevenly. These conditions are referred to as congenital (present at birth). In other cases, the spine may not grow as straight as it should without a known cause or means of prevention, which is known as idiopathic.
Although the spine does curve from front to back, it should not curve sideways very much. A side-to-side curve, called scoliosis, may take the shape of an "S" (double curve) or a long "C" (single curve).
Scoliosis is more than just a curve to the side. The scoliotic spine is also rotated or twisted. As the spine twists, it pulls the ribs along with it, so that one side of the chest becomes higher than the other or the shape of the breastbone may change. One shoulder may be higher than the other or clothes may hang unevenly at the waist, because one hip is higher than the other.
Idiopathic scoliosis, which accounts for 80-85 percent of scoliosis cases, develops gradually over time and may worsen quickly during rapid growth in the preteen and teen years.
Early detection of abnormal spinal curves by school screening programs and pediatricians is intended to find scoliosis early enough to begin brace treatment and avoid surgery. Once an abnormal spine curve has been detected, it is important to monitor the curve during growth. Your child's physician will work with your family to decide on a treatment plan and follow-up based upon X-rays and physical exam. Even though your child’s curve may not bother her now, it should be watched throughout growth.
Scoliosis rarely seems a problem to the teen patient. However, it is necessary to monitor curves because adults with moderate or severe scoliosis can have progressively worsening curves, which cause cosmetic disfigurement, back pain and in the worse cases, difficulty breathing. Treatment after the curve has already become severe in adulthood is much less successful than treatment during childhood or adolescence. By finding progressive curves early, we hope to keep them from becoming problems in adulthood.
Whether your particular spinal conditional is congenital, idiopathic or neuromuscular related, the Orthopedic Center's Spinal Program provides comprehensive treatment including evaluation, diagnosis, consultation and follow-up care.
Once an abnormal spine curve has been detected, it is important to monitor the curve. In many cases, a child's spinal condition may only require close monitoring during skeletal growth. The physician will decide on the treatment plan and follow-up based upon x-rays and the physical exam.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”