Scoliosis is a lateral deviation of the spine, which is mostly diagnosed in adolescence and is evidenced by observing a person's back. It can occur in patients with infantile cerebral palsy, muscular dystrophy or spinal cord injury, but in 80% of people the cause is unknown.

In most cases there is no cause, although this disease has a large hereditary component, since this disorder is usually transmitted from parents to children.

There are other less common types of scoliosis that may accompany the following problems:

• Cerebral palsy or muscular dystrophy.
• Defects in the formation of the vertebral bodies during pregnancy
• Thoracic surgery in patients under 10 years of age   
• Infections of the disc and/or vertebra.
• Vertebral tumors
• Spinal cord anomalies such as spina bifida occulta, myelomeningocele.
• Secondary to a genetic syndrome such as neurofibromatosis, mucopolysaccharides, arthrogryposis, VACTER, among others.

• Weakness or feeling of tiredness in the back.
• Back pain, leg cramps,
• Asymmetrical shoulders, one higher than the other.
• One shoulder blade appearing more prominent than the other.
• Asymmetrical waist.
• One side of the waist appears higher than the other.
• One part of the rib cage (the ribcage) is clearly higher than the other
• When leaning forward (Adams maneuvers) protrudes more on one side of the back and/or rib than the other.

There are 4 groups of scoliosis: 

• Idiopathic scoliosisThe cause is unknown, it is the most common, 8 out of 10 patients with scoliosis present this type and it is more frequent in women.
• Congenital (from birth) ScoliosisThis is caused by an abnormal formation of the vertebrae, either because they are formed incompletely or are joined together in an inadequate manner.
• Neuromuscular Scoliosiscaused by diseases that damage the spinal cord, the nerves that come out of it or the muscles of the spine, for example: cerebral palsy, myelomeningocele, spinal muscular atrophy, muscular dystrophies, polyneuropathies, among others.

Secondary ScoliosisSecondary Scoliosis: after a spinal fracture, vertebral or spinal tumors, bone infections, among other rare genetic syndromes.

• AgeSigns and symptoms mostly begin in adolescence.
• SexIt is more common in women than in men with a 2:1 ratio.
• Family historyWhen you have a family member with scoliosis such as parents, grandparents or siblings.

• Respiratory problems: due to the decrease in the size of the rib cage this occurs when the curvature is above 70.

• Significant cosmetic deformity of the back and rib cage, as scoliosis worsens, causes more noticeable changes, including asymmetrical hips and shoulders, more prominent ribs, and a shift of the waist and trunk to one side. 
• Untreated scoliosis has a high likelihood of chronic pain in adulthood, especially if its abnormal curves are large.
• Alterations in mood and self-esteem.
• Nutritional alterations, severe deformities decrease the size of the gastric chamber and do not allow adequate feeding. 

Most cases of scoliosis are mild, but some deviations worsen as children and adolescents get older. Severe scoliosis can be disabling because it reduces the size of the rib cage, decreasing the space for the lungs, which makes it difficult for the respiratory system to function properly.

Mild curvatures in the spine may form without you or anyone else noticing, since they develop progressively and usually do not cause pain. Sometimes teachers, friends or other people in your social circle are the first to notice the back deformity.

When attending the consultation, a comprehensive assessment is generally performed where the following evaluations are made: 

• Sensitivity, strength and reflexes in hands and legs, 
• The back is observed to identify signs of scoliosis (shoulders, ribs, shoulder blades and waist). 
• The Adams maneuver is performed in order to measure the degree of rotation of the vertebrae with the help of the scoliometer and to make the deformities more evident.
• Depending on the case, we rely on diagnostic aids such as panoramic radiography of anteroposterior and lateral spine, scoliosis test and in some patients we perform total spine resonance imaging.