View Full Version : Structural Scoliosis?

25-01-2012, 12:34 PM

I wanted to ask a couple of questions but mainly if a proturded rib indicates structural scoliosis rather than functional? AS i've heard functional scoliosis is alot easier to treat. Also is it possible that scoliosis can lead to other conditions such as winged scapulas? Thank you!

Dr Scoliosis
27-01-2012, 05:59 PM
Thank you for your enquiry. You will have to provide some more information before an answer can be given to your first question. A protruded rib indicates one rib is prominent and that certainly does not indicate a structural scoliosis. For nearly all structural curves, that is a curve which cannot be brought back into normal alignment, there are at least five or six ribs involved and as the spine curves sideways and rotates, so the ribs also rotate because of their jointing with the spine. Strictly speaking there is no such thing as a functional scoliosis. Could you please clarify what you mean by that term.

In the typical thoracic scoliosis of adolescents the right scapula does become more prominent because the ribs rotate backwards as well as slightly upwards. That is something quite different from a "winged" scapula. The latter results from a paralysis of a specific muscle, the serratus anterior, which holds the scapula against the chest wall.

Please be assured I am not trying to be difficult but rather to answer your questions in a manner so that you will not get misleading impressions.

Dr Scoliosis

30-01-2012, 11:27 AM
Functional scoliosis: A structurally normal spine that appears to have a lateral curve (scoliosis).
Nonstructural scoliosis involves a temporary change of spinal curvature. This is caused by an underlying condition such as a difference in leg length, muscle spasms, or inflammatory conditions, (e.g. appendicitis (http://www.medterms.com/script/main/art.asp?articlekey=280)), which may produce muscle spasm. Functional scoliosis is treated by correcting the underlying problem. The spine itself needs no treatment.
Functional scoliosis is also called nonstructural scoliosis as opposed to structural scoliosis in which there is a fixed curve of the bones of the spine (the vertebrae)."

Quoted from http://www.medterms.com/script/main/art.asp?articlekey=10387

From my understanding functional scoliosis is caused by something other than the spine itself, such as maybe a uneven hip? Or does scoliosis end up with a uneven hip? If one has a protruded rib on the right hand side, would it be expected that the left scapula be more prominent?

Thank you for the reply Dr Scoliosis, it is much appreciated.

Dr Scoliosis
30-01-2012, 06:20 PM
Most surgeons who work in this field would not accept the term functional scoliosis as you have detailed it.

It is important that correct terminology is used. If you look at the section on radiology (http://www.scoliosis-australia.org/scoliosis/radiologist_role.html) on our website you will note that it is strongly advised that the term scoliosis should not be used to describe a lack of deviation unless it measures more than 10 degrees and, most important, there is associated rotation. Functional scoliosis such as you have described it is simply a lateral tilt of the spine and is not accompanied by rotation and the tell-tale signs are on the plain x-rays.

I find your last paragraph hard to understand. If a scoliotic spine, that is one with a true structural scoliosis, is out of balance then one hip region will appear more prominent than the other. That is, the centre of gravity of the trunk moves away from the mid line. However, it is the pelvis which is prominent and not the hip itself.

It is suggested that you read the cited paper on the radiology of scoliosis in which these matters are discussed in full with illustrations.

Dr Scoliosis