Scoliosis Diagnosis and Phenotype
Not all Scoliosis is the same. Some curvatures are very flexible, while others are rigid and stiff. Understanding what type (phenotype) of scoliosis you are dealing with can help determine the best non-surgical treatment.
Scoliosis diagnosis can be missed until the curvature is severe. Early diagnosis can be important if followed by early intervention.
Scoliosis diagnosis may be made by a Chiropractor, Primary care doctor or the Pediatrician. Scoliosis X-rays should be taken in the standing neutral position with the patient self positioned.
Assessing Spinal Stiffness Measurements can help determine what type of non-surgical Care is most appropriate.
Scoliosis Diagnosis can also be made by your Dentist!
Studies confirm patients with scoliosis are 10 times more likely to have hereditary orthodontic anomalies such as hypodontia, and show comorbidity 20 percent of the time with other anomalies such as progenia, close bite and primary compression (Pecina 1991). This is evidence to support the genetic predisposition for both orthodontic and spinal deformity.
Another important study revealed Class 2 malocclusions to be linked to scoliosis (Lippold et al).
Fig. 1: Radiograph of a 9-year-old girl with a Class II malocclusion and scoliosis, (a) radiograph of the entire spinal column showing a scoliotic inward lumbar curvature with a 12_ convexity on the left side and at the thoracic level aminimal vertebral rotation of 13_, (b) cephalometric profile film showingthe Class II malocclusion associated with a retrusion of the mandible and a slight maxillary protrusion, (c) frontal cephalogram showing no notable signs of asymmetry (Amat 2009).
Other conditions such as Overjet deformity and posterior and anterior cross bites have also been identified in higher numbers in patients with comorbid scoliosis (Ben-Bassat 2006).
These studies suggest dentists should refer for scoliosis evaluation when dento-facial asymmetry is diagnosed at an early age. Scoliosis treatment is more effective when it is started early, and measures can be taken to improve postural control and awareness before spinal deformity becomes permanent.