Scoliosis is classified according to cause, location, and severity of the curvature:

1. By cause:
   • Idiopathic scoliosis: Cause unknown, most common form, particularly in adolescents.
   • Congenital scoliosis: Congenital malformation of the vertebral bodies.
   • Neuromuscular scoliosis: Caused by conditions such as muscular dystrophy or cerebral palsy.
   • Degenerative scoliosis: Age-related change of the spine, often associated with osteoarthritis.
2. By location:
   • Thoracic scoliosis: Curvature in the thoracic spine region.
   • Lumbar scoliosis: Curvature in the lumbar spine region.
   • Thoracolumbar scoliosis: Transitional area between the thoracic and lumbar spine.
3. By severity (Cobb angle):
   • Mild: Up to 20 degrees.
   • Moderate: Between 20 and 40 degrees.
   • Severe: Over 40 degrees.

The causes depend on the type of scoliosis:

• Idiopathic scoliosis:
  • No clearly defined cause, but possibly genetically determined.
• Congenital scoliosis:
  • Malformations of the vertebral bodies during embryonic development.
• Neuromuscular scoliosis:
  • Weakness or imbalance of the back muscles, e.g., in muscular dystrophy.
• Degenerative scoliosis:
  • Wear of the intervertebral discs and vertebral joints due to aging.
• Risk factors:
  • Family history, growth phases in adolescence, or existing neurological disorders.

Symptoms depend on the severity and progression of the curvature:

• Asymmetry: Uneven shoulders, a prominent shoulder blade, or an uneven waist.
• Pain: Back pain, especially with degenerative scoliosis or with advanced curvature.
• Movement limitations: Reduced flexibility and mobility of the spine.
• Breathing problems: With severe curvatures of the thoracic spine, lung function may be impaired.
• Neurological symptoms: Tingling or numbness with pressure on nerves.

The diagnosis is made through a thorough medical history, physical examination, and imaging procedures:

• Medical history:
  • Assessment of symptoms, family history, and growth pattern.
• Physical examination:
  • Visual inspection of the spine in the forward-bending position (Adam test).
  • Measuring shoulder and pelvic height to identify asymmetries.
• Imaging:
  • X-ray: For precise measurement of the Cobb angle and determination of the curvature pattern.
  • MRI or CT: If neurological involvement is suspected or for detailed analysis of malformations.

Conservative therapy

In most cases, conservative treatment is sufficient, especially for mild and moderate curvatures:

• Physiotherapy:
  • Targeted exercises to strengthen the back muscles and improve posture.
  • Methods such as Schroth therapy to correct the misalignment.
• Corset therapy:
  • Use of individually fitted corsets to prevent the progression of the curvature, especially in idiopathic scoliosis during the growth period.
• Pain management:
  • NSAIDs: To relieve back pain.
  • Heat therapy or massages for tension.

Surgical therapy

Surgery is considered for severe curvatures or rapidly progressive scoliosis:

• Spinal fusion (spondylodesis):
  • Fixation of the spine with metal implants and correction of the curvature.
• Disc prostheses: In degenerative scoliosis to restore vertebral height.
• Decompression: Relief of nerves in cases of neurological symptoms.

To prevent scoliosis or to support treatment, the following measures are suitable:

1. Early detection: Regular examinations in children during growth phases.
2. Posture training: Promoting an ergonomic sitting and standing posture.
3. Regular physical activity: Sports such as swimming or Yoga to strengthen the back muscles.
4. Avoidance of heavy loads: Avoiding one-sided strain from heavy lifting.
5. Follow-up examinations: Regular X-ray examinations for existing curvatures.