Lumbar scoliosis affects the spines of prepubescent children. Unlike other forms of scoliosis that can cause curves in the upper and middle areas of the spine, lumbar scoliosis causes a curve to form in the lower spine, near the tail bone. Scoliosis affects people in various ways, and researchers are still working to determine all the causes of the condition.
Frequency and Causes
Scoliosis occurs primarily in children. It typically becomes noticeable when a child enters her growth spurt just before the onset of puberty. In fact, the disease rarely occurs in anyone younger than 10 years of age. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 3 to 5 out of every 1,000 children will develop curvature of the spine severe enough to be treated. The disease tends to run in families and girls are usually more severely afflicted than boys. Scoliosis can be caused by pre-existing genetic conditions, such as Marfans syndrome or muscular dystrophy, or temporary underlying conditions, such as spasming muscles or appendicitis. Cases caused by temporary underlying conditions usually disappear when the underlying condition is addressed. Even though some cases of scoliosis are caused by underlying conditions, doctors cannot determine the primary cause for the disease in 80 to 85 percent of cases.
Effects and Treatment
Lumbar scoliosis can cause children to appear as if they have an uneven waist, with one hip sitting higher than the other. If the scoliosis progresses enough to become severe, the hips may even twist to the side, potentially causing lower back pain and difficulty walking. Doctors can choose from among three treatment options for children with scoliosis. In mild cases, a doctor may choose to observe patients and reassess the situation every 4 to 6 months. If the curvature continues to increase, a doctor might recommend that the child wear a brace to prevent further curvature from developing as he grows. If the curve become too severe, the doctor may perform surgery to attempt to correct it. There are alternative treatments for scoliosis. According to the Mayo Clinic, however, none of them have been proven to be effective. These include chiropractic manipulation, electrical stimulation, nutritional supplementation and exercise.
Spondylolisthesis Connection
One potential cause of childhood lumbar scoliosis is a congenital condition called spondylolisthesis. In this condition, a child's fifth lumbar vertebra slips forward onto the first bone of the sacrum, or tail bone. Some children with spondylolisthesis experience no symptoms, but others have lower back pain, muscle tightness in the hamstrings, pain in the thighs and buttocks and tenderness in the area of the slipped disc. In 2008, Jonathan Peterson and Dr. Dennis Wenger of Rady Children's Hospital in San Diego conducted a study that explored spondylolisthesis as a cause of lumbar scoliosis; they published their results in the "Iowa Orthopaedic Journal." Using computerized tomography images, they showed that mild spondylolisthesis may in fact be the primary mechanical, or foundational, cause of non-genetic lumbar scoliosis.
References
- The National Institute of Arthritis and Musculoskeletal and Skin Diseases: Scoliiosis
- Mayo Clinic: Scoliosis
- The Iowa Orthopedic Journal: Asymmetric Spondylolisthesis as the Cause of Childhood Lumbar Scoliosis---Can New Imaging Modalities Help Clarify the Relationship?
- Medline Plus: Spondylolisthesis
