Scoliosis

What is scoliosis?

Scoliosis is an abnormal lateral curvature of the spine, typically accompanied by rotation of the vertebrae, giving the spine a three-dimensional deformity rather than a simple sideways bend. A normal spine viewed from behind is straight. In scoliosis, it curves to one or both sides, forming a C or S shape.

Scoliosis is classified by cause:

• Idiopathic: the most common type (80% of cases) with no known cause. It most often appears during the teenage years.

• Degenerative: develops in older adults as spinal discs and joints wear down unevenly over time.

• Congenital: caused by spinal bones that didn't form correctly before birth.

• Neuromuscular: results from conditions like cerebral palsy or muscular dystrophy that affect muscle control.

• Secondary: caused by specific underlying issues like spinal tumours or cysts, which are detectable on MRI.

Severity is assessed by the Cobb angle, the standard measurement of spinal curvature on imaging.

• Normal: below 10 degrees.

• Mild: 10 to 25 degrees.

• Moderate: 25 to 40 degrees.

• Severe: over 40 degrees (more likely to require surgery or bracing).

Symptoms of scoliosis

Mild scoliosis frequently causes no symptoms and is often discovered incidentally on imaging. As curvature increases, symptoms may include:

• Visible asymmetry of the shoulders, waist, or hips

• One shoulder blade more prominent than the other

• Uneven waistline or clothing that hangs crookedly

• A rib hump visible when bending forward, from vertebral rotation

• Persistent back pain or muscle fatigue, particularly on the concave side of the curve

• Reduced flexibility and range of spinal motion

• In severe curves: shortness of breath from thoracic cage deformity restricting lung expansion

• In secondary scoliosis from a spinal cause: neurological symptoms including leg weakness, numbness, or bladder and bowel dysfunction

What causes scoliosis?

The cause depends on the type of scoliosis. For the most common form, idiopathic scoliosis, the cause is not fully understood. Contributing factors include:

• Genetic predisposition idiopathic scoliosis runs strongly in families. First-degree relatives of affected individuals have a significantly elevated risk, suggesting a dominant genetic component.

• Growth-related factors adolescent idiopathic scoliosis typically develops or worsens during growth spurts, suggesting a relationship between skeletal growth velocity and curve progression.

• Asymmetric disc and facet degeneration drives degenerative scoliosis in adults through uneven load distribution and progressive structural collapse.

• Vertebral malformations cause congenital scoliosis through asymmetric growth of abnormally formed vertebrae.

• Neurological and muscular conditions cause neuromuscular scoliosis through imbalanced muscle pull on the spine.

• Spinal tumours, syrinx, and tethered cord cause secondary scoliosis and must always be excluded with MRI in atypical or progressive cases.

How is scoliosis detected?

Scoliosis is detected primarily through spinal imaging, with blood tests providing relevant metabolic and bone health context.

Spinal MRI Elfcare’s full-body MRI scans the entire spine to identify curvatures and rotations. It is particularly valuable for identifying secondary causes, like tumors, cysts, syrinx, or tethered cord, that might be driving the curve. It also assesses disc wear and tear, which is especially important for evaluating degenerative scoliosis in adults.

Blood tests cannot detect scoliosis directly but assess the bone and metabolic health context most relevant to spinal structural integrity and long-term management. Relevant markers in Elfcare's panel include:

• Vitamin D and calcium: essential for bone density; low levels can weaken the vertebrae and worsen spinal issues.

• ALP: measures bone turnover; high levels can signal metabolic bone disease.

• Magnesium: supports both bone strength and the muscle function needed to stabilize the spine.

• CRP: checks for inflammation that could be linked to underlying spinal conditions.

• HbA1c and glucose: high blood sugar can accelerate the breakdown of spinal discs.

• TSH: screens for thyroid issues, which directly impact bone metabolism and strength.

Why early detection matters

Mild scoliosis identified early in adolescence can be monitored and, where curves are progressing, treated with bracing that prevents the curve from reaching surgical thresholds. Without monitoring, a progressive curve can worsen significantly during growth spurts without causing obvious symptoms, reaching a degree where surgical correction becomes necessary. In adults, early identification of degenerative scoliosis allows for physiotherapy, core strengthening, and pain management strategies that slow progression and preserve function. Identifying secondary causes such as a spinal tumour or syrinx early through MRI allows for treatment of the underlying cause, which often halts curve progression.

How Elfcare can help

Elfcare's full body MRI covers the entire spine from cervical to lumbar as standard, directly imaging spinal curvature, vertebral rotation, disc health, and any secondary causes of scoliosis. For someone with a known or suspected spinal curvature, this comprehensive structural assessment identifies both the degree of curvature and any underlying pathology that standard X-ray-based assessment would miss.

Our blood panel covers vitamin D, calcium, magnesium, ALP, and metabolic markers, supporting the overall bone health picture relevant to scoliosis management and progression.

If our MRI identifies scoliosis or a related spinal finding, we take care of further diagnostics or refer you to the appropriate specialist.