“Idiopathic” is a big word that describes a very simple concept. Merriam-Webster notes that it combines the Greek word “idios” (i.e. “one’s own”) and the suffix “-pathic” (a root that suggests disease or dysfunction). In short, an idiopathic disease is one that springs up spontaneously — one for which medical science and professionals have no agreement on its origins.
One of the most puzzling conditions doctors face is idiopathic scoliosis. According to the American Association of Neurological Surgeons, idiopathic scoliosis accounts for 80 percent of all scoliosis cases. While it can manifest itself during early age, it typically presents in pre- or early adolescence for reasons that have yet to become clear. Suspicions about the condition typically arise when family members or school officials notice an abnormality on a young person’s back.
When wondering if an individual might have idiopathic scoliosis, a degenerative spine disorder, or some similar disease, that person’s loved ones might consider whether or not it’s normal to have a curved spine. Unfortunately, the answer isn’t always cut and dried. Having a curved spine may be normal — and it may indicate a problem. The difference lies in the details. Read on to learn more.
How Many People Are Affected by a Curved Spine?
In normal, healthy individuals, the spine always curves. However, it occurs in a very specific way. SpineUniverse explains that this curve is normally only visible when viewed from a side (aka lateral) view. From this vantage point, the neck and the lower spine tilt inward, a natural movement that keeps the bulk of one’s mass situated over the pelvis. The spine then typically shifts outward around the chest and hips. This outward movement is called kyphosis, and the inward movement is called lordosis.
If you have read about spinal disease before, you’ve probably heard those two words. In fact, it may seem confusing to hear them referred to as normal movements of the spine, because those terms are usually used to indicate spinal pathologies — and with good reason. Normal spinal bends can become diseases when angles grow too extreme. Scholarly round-up site ScienceDirects notes that a lordotic curve of more than 35 degrees in the neck and a curve of more than 60 degrees in the lower back likely indicates a problem. ScienceDirect also points out that a kyphotic curve greater than 45 degrees may benefit from treatment. Additionally, a loss of the typical lordotic curve may lead to conditions such as flat-back syndrome.
Forward and backward tilting isn’t the only way that the spine’s angles can change. When viewed from the back (aka posterior), it can also shift to one side or another. This is not a normal movement. While the spine doesn’t have to be perfectly straight when examined from the posterior, it should nearly be. Any deviation to the left or the right by more than 10 degrees meets the definition for scoliosis.
Though a diagnosis or even suspicion of scoliosis might seem upsetting, understand that it’s a very common condition. SpineUniverse accurately states that about 3 million cases are diagnosed each and every year in the United States. However, very few of these cases require surgical intervention.
What Are the Common Causes of a Curved Spine?
When discussing scoliosis (which we will do in more detail in the next section), doctors often can’t pinpoint a specific cause for the condition. But that doesn’t mean there aren’t certain factors that may indicate the presence of the disorder and help with its treatment.
Other sorts of curves in the spine may arise from a variety of diverse causes. Lordosis can be caused by osteoporosis, bone cancer, obesity, and spondylolisthesis (a condition that occurs when a vertebra becomes displaced). Meanwhile, Kyphosis can develop from perpetually poor posture, arthritis, muscle weakness, infection, and birth defects.
Although we have only mentioned two specific conditions, understand that any circumstance which causes vertebrae to somehow shift or change their angle may result in a curved spine. These include trauma or genetic abnormalities, inflammation, or bone degeneration. In fact, a single diagnosed spinal condition can develop and progress due to a wide range of different underlying reasons.
Scoliosis: Hereditary, Genetic or Environmental?
This principle also holds true when dealing with scoliosis. Yes, in approximately three out of every four cases, doctors cannot pinpoint a specific cause. However, the remaining cases originate from very distinct sources, and statistics surrounding idiopathic scoliosis suggest potential origins for the condition.
For instance, congenital scoliosis occurs when abnormalities appear during gestation. Neuromuscular scoliosis owes to other conditions such as spina bifida, cerebral palsy, muscular dystrophy, polio, or spinal cord injury. Adult scoliosis is usually prompted by concomitant degenerative condition and is distressingly common in the aging population. U.S. News & World Report states it is “estimated that 40 to 60 percent of adults will develop degenerative scoliosis by age 65.”
Idiopathic scoliosis has no clear origin. Still, statistics surrounding it cluster in noteworthy ways. This kind of scoliosis frequently occurs during adolescence, which is a time of rapid skeletal growth. Scoliosis Research Society notes that 30 percent of adolescent scoliosis patients “have some family history of scoliosis, which would indicate a genetic connection.” And while WebMD states that about the same number of boys and girls receive a scoliosis diagnosis, “curves in girls are 10 times more likely to get worse and may need to be treated.” So, if you have a family history of scoliosis and a young preteen or teenage girl in your household, you should remain particularly vigilant.
How can you tell if a loved one’s curved spine is really scoliosis? There is a common test you can perform at home called the Adam’s Forward Bend Test. It involves a potential patient and an observer. The patient removes his or her shirt, and the observer watches as he or she bents forward. Once the patient reaches a 90-degree angle, he or she ought to stretch fingers toward toes, taking the position of someone preparing to jump off of an imaginary diving board. Any asymmetrical patterns in the torso or the spinal column should be visible to the observer.
Of course, no single test is perfect in correctly diagnosing spine issues, and the Adam’s Forward Bend Test can produce false positives. If you’re truly concerned about whether or not your loved one has an abnormally curved spine, contact or call The Spine Center directly at (847) 628-8147. Our fellowship-trained surgeons pride themselves on education and ensuring our patients retain their functionality.