Scoliosis can range from mild scoliosis to severe, and there are also different curvature types and locations within the spine. While most cases of scoliosis are classified as idiopathic, meaning cause unknown, there are also condition types associated with known causes, including cases of levoscoliosis.
Characteristics of scoliosis differ from one patient to the next, including experienced symptoms and treatment needs. A typical scoliotic curve will bend to the right, but an atypical curve can bend to the left, towards the heart; this is diagnosed as levoscoliosis.
When I see a left-bending curve on an X-ray, this indicates an atypical condition type that can be particularly disruptive to spinal health and requires a more-complex treatment process.
A healthy spine is naturally curved, and these curves increase the spine's strength, flexibility, and facilitate its ability to absorb and distribute stress from impact and movement.
Considering the benefits of maintaining the spine's healthy curves, what happens when a healthy spinal curvature is replaced by an unhealthy curve?
In cases of scoliosis, the spine curves unnaturally to the side and also rotates, and as scoliosis is progressive, scoliosis curves can become more pronounced over time.
In order to diagnose scoliosis, a physical exam and an X-ray have to be performed; it's during an X-ray that I can really see what's happening to the spine, and the direction in which the unnatural curvature of the spine bends is important.
In most typical cases of scoliosis, dextroscoliosis is diagnosed, which means the scoliotic curvature bends to the right; this is typical.
There are also atypical cases that feature curves that bend to the left: levoscoliosis.
In the majority of known diagnosed scoliosis cases, we don't know the cause, and cases of idiopathic scoliosis account for 80 percent of known cases, but what about the remaining 20 percent?
The remaining 20 percent of known cases are associated with known causes, and these types are considered atypical and include neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis.
In typical cases of idiopathic scoliosis, the curve will bend away from the heart, towards the right side of the body, so when I see a curve bend to the left side, this is levoscoliosis and is a red flag that the scoliosis has an underlying cause; this is significant because it can shape a condition's potential effects and treatment needs.
So the answer to what causes levoscoliosis will vary based on the type in question.
My neuromuscular scoliosis cases can be among the most complex to treat; this is because the scoliosis was caused by a larger underlying medical condition such as cerebral palsy, spina bifida, or muscular dystrophy.
There are a number of neuromuscular disorders capable of causing the development of scoliosis as a related complication; neuromuscular conditions cause a disruption in communication between the brain, the spine, and the muscles and connective tissues that are key to spinal support/stability.
There is a big difference between addressing the symptoms of levoscoliosis or the cause of it, and as the cause is a neuromuscular condition, the larger neuromuscular condition has to be the focus of treatment.
Symptoms of neuromuscular levoscoliosis can be particularly severe with some patients becoming unable to walk on their own and confined to a wheelchair.
Degenerative scoliosis affects older adults and is caused by age-related spinal degeneration, and in most cases, this starts with the spine's intervertebral discs.
A disc sits between adjacent vertebral bodies and provides the spine with structure; they also provide cushioning between adjacent vertebrae to prevent friction, combine forces to make the spine more flexible, and absorb and distribute shock from impact.
If a disc starts to deteriorate, it changes shape, and as adjacent vertebrae attach to the disc in between, this can also disrupt the position of nearby vertebrae, causing them to become unnaturally tilted to the side, disrupting spinal alignment.
Treating adult scoliosis patients involves improving the spine's stability, while preserving existing spinal strength and flexibility, and this can involve gentle chiropractic adjustments and a variety of therapies including physical therapy.
When treating scoliosis, a patient's skeletal maturity is taken into account because this indicates the level of potential progression a patient can face, and when it comes to treating adult degenerative scoliosis, pain management is a focus because pain will affect adult scoliosis patients more once skeletal maturity is reached, and even more so once spinal degeneration occurs.
Symptoms of degenerative scoliosis commonly include pain (moderate to chronic back pain, chest pain, muscle pain, and nerve pain) and disruptions to movement as the spine becomes more unstable and unbalanced as the condition progresses.
Scoliosis that babies are born with is called congenital scoliosis and involves spinal malformations that developed in utero, and this type is rare, affecting approximately 1 in 10,000.
Spinal malformations can include vertebral bodies forming in more of triangular shape than rectangular, making it difficult for the spine to form in an aligned position, and another common malformation involves the failure of vertebrae to form into distinct and separate bones, instead becoming fused together, causing them to wedge forward unnaturally.
Symptoms of congenital scoliosis include postural asymmetries such as uneven hips and shoulders, and as scoliosis progression is triggered by growth, as an infant grows, the condition's effects can become more overt.
Observing for progression is important, as is modifying treatment plans to account for the unique challenges associated with treating patients of such a young age.
Comprehensive assessment of congenital scoliosis patients is also important because additional congenital abnormalities are common.
There is another atypical condition type that can feature a left-bending curve: traumatic scoliosis.
The presence of spinal tumors can also cause scoliosis to develop by pushing on the spine, and the uneven pressure can cause the spine become misaligned and vulnerable to the development of an unnatural spinal curvature.
In these cases, the underlying injury, and/or the presence of tumors, has to be the focus of treatment as the underlying cause of the scoliosis.
The more atypical and severe scoliosis is, the more likely it is that surgical treatment options will be recommended.
While typical cases of scoliosis can be highly treatable and responsive to non surgical treatment, more severe scoliosis cases can involve a spinal fusion recommendation.
Scoliosis surgery is invasive and can disrupt the spine's overall health, strength, flexibility, and range of motion, so while some cases of levoscoliosis can benefit from a surgical response, developing scoliosis doesn't always mean guaranteed future spinal surgery.
Addressing an unnatural spinal curve bend with surgery involves the removal of intervertebral discs between vertebral bodies to be fused, the fusing of the vertebrae at the curve's apex where they are the most unnaturally tilted, and attaching metal rods to the spine to maintain its alignment.
And the sooner scoliosis is diagnosed and treatment is started, the better, regardless of the form of scoliosis and/or the level of scoliosis severity.
What's most important to understand about scoliosis is that all cases require treatment because as a progressive condition, leaving scoliosis untreated can lead to preventable complications.
Levoscoliosis is considered atypical because it can involve left-bending spinal curves, is associated with known causes, and tends to involve particularly severe cases.
Adolescent idiopathic scoliosis is the most common type of scoliosis overall, and atypical conditions types include neuromuscular scoliosis, degenerative scoliosis, congenital scoliosis, and traumatic scoliosis.
Scoliosis can develop in the cervical spine, the thoracic spine, or the lumbar spine, and/or in multiple sections, and symptoms of scoliosis are shaped by key patient and condition variables, including the level of nerve and muscle involvement.
All cases of scoliosis can benefit from proactive treatment options, and as a CLEAR-certified scoliosis chiropractor, treatment integration is key and combines the power of chiropractic rehabilitation, physical therapy, corrective bracing, and rehabilitation.
The best way to manage symptoms of scoliosis such as pain and poor posture is to treat it proactively, and this involves determining a condition's underlying cause and shaping treatment plans accordingly.
Here at the CLEAR Scoliosis Institute, regardless of the form of scoliosis, treatment efficacy involves reducing the size of the unnatural spinal curve and core strengthening for optimal spinal support and stability.
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