Understanding Thoracolumbar Scoliosis: Causes, Symptoms, and Treatment Options

Thoracolumbar scoliosis is a specific form of scoliosis that impacts the region where the upper and lower back converge, leading to a curvature in the spine. This condition can be managed through vigilant monitoring of the curve, the use of a brace, or surgical intervention. Scoliosis is a relatively common condition, with the American Association of Neurological Surgeons estimating that 2–3% of the US population, or roughly 6–9 million individuals, are affected. However, as mild scoliosis can often be symptom-free and therefore undiagnosed, the actual number could be higher.

Thoracolumbar scoliosis is among the most prevalent forms of this condition. A 2013 study reported that thoracolumbar or lumbar scoliosis accounted for 40% of adolescent cases, with boys being more susceptible to this type of curvature. Thoracolumbar scoliosis is identified when it impacts the chest and mid-back area (thoracic spine) and the upper section of the lower back (lumbar spine).

Individuals with thoracolumbar scoliosis may experience pain, either due to the spinal curve itself, nerve compression in the area, or both. Additional symptoms can include a bulge in the back, uneven waist or ribcage, uneven shoulders, or a visible lean to one side. Some individuals may also experience a loss of height or shortness of breath. However, not everyone with scoliosis experiences these symptoms — it can often be asymptomatic.

Scoliosis is most prevalent in young children and adolescents, with a higher likelihood of development if a parent or sibling has the condition. However, it can also develop in adulthood due to osteoporosis or degenerative changes in the spine. There are three main types of scoliosis: idiopathic, congenital, and neuromuscular. Idiopathic scoliosis, where the underlying cause is unknown, is the most common type, accounting for 80% of cases. Congenital scoliosis occurs when the ribs or spine don’t form properly during fetal development, while neuromuscular scoliosis is a result of a neurological or muscular condition.

Diagnosis of thoracolumbar scoliosis follows the same process as other types of scoliosis, involving a physical exam and X-rays. Treatment options vary depending on the patient’s age, the location and degree of the curve, and the likelihood of the curve progressing. Monitoring, bracing, physical therapy, and surgery are all potential treatment methods.

Scoliosis is a lifelong, often progressive condition. For many, scoliosis worsens with age. However, with careful monitoring or physical therapy, individuals with thoracolumbar scoliosis may be able to manage their condition for many years. If scoliosis significantly impacts quality of life, surgical correction of the spine can help alleviate pain and other symptoms.