Progression of Scoliosis-Lakewood
Whatever the root cause of a scoliosis, it will usually begin as a small, flexible scoliosis. At this stage, the spine is still capable of going through its normal range of motion (more or less).
In a small, flexible, or “functional” scoliosis, lateral bending X-rays would show an easy correction of the curve when bending the spine sideways to the left and right.
As a scoliosis grows, increasing distortion occurs in the soft tissues of the spine, which leads to loss of normal range of motion. When normal range of motion is lost, severe stiffness can set in.
Structural vs. Functional Scoliosis
Structural scoliosis is a term applied when the curve has become stiff, inflexible, and rigid. Calling a scoliosis “structural” does NOT mean the curve was caused by a structural asymmetry, such as a wedge-shaped vertebra. It would be more accurate to simply call the scoliosis “rigid” instead of “structural.” Some doctors seem to prefer the use of the word “structural” in order to divide scoliosis into two categories:
- Functional (flexible)
- Structural (rigid)
This may be considered a false dichotomy as most curves have BOTH some functional and some structural qualities. Also, using the term “structural” for a curve that is rigid creates the false impression that the curve is being caused by bones that are “structurally” misshaped. In truth, larger, rigid curves have relatively minimal distortion in the bones. Finally, the term “structural” is often used to communicate to the patient that nothing at this point could straighten the spine, except surgery. As you will see, this is not the case
