Skolyoz

Skolyoz (scoliosis) is a sideways curvature of the spine with vertebral rotation, often producing a rib prominence on the convex side when the person bends forward. It is a common spinal deformity that typically begins during childhood or adolescence as growth spurts.

Most cases are idiopathic, with no identifiable cause. Other forms include congenital scoliosis (vertebral anomalies present at birth), neuromuscular scoliosis (associated with conditions such as cerebral palsy or muscular dystrophy), and syndromic scoliosis.

Signs and symptoms range from subtle to noticeable. Physical findings may include uneven shoulders, a tilted pelvis, and a rib hump on forward bending. In adults, back pain may occur; severe deformities can affect posture and, in rare cases, lung function.

Diagnosis combines physical examination with imaging. The Adams forward-bend test is a screening tool; standing X-rays measure the Cobb angle to quantify the curvature. MRI may be used to exclude intraspical abnormalities if suggested by exam or atypical features. Classification also distinguishes between structural (fixed) and non-structural (reversible) curves.

Treatment depends on curve size and skeletal maturity. Mild curves may simply be observed with periodic imaging. Moderate curves in growing patients are often managed with bracing to slow progression. Good evidence supports bracing for thoracic and thoracolumbar curves in skeletally immature individuals. Exercise therapy may be used as an adjunct.

Surgery, usually posterior spinal fusion with instrumentation, is considered for large or progressively deforming curves (commonly around 45–50 degrees). The goal is to straighten and stabilize the spine while preserving growth when possible.

Prognosis is generally favorable with appropriate monitoring and treatment. The condition is more common in girls, and prevalence in adolescents is a few percent.