All you need to know about levoscoliosis
From a side view, the spine typically curves to some extent at the neck and lower back, forming a wide "S" shape. But from the back and front view, the spine usually appears mostly straight.
In people with levoscoliosis, from the back view, the spine appears to take on a hard "C" or "S" shape, leaning to the left.
How is it caused?
Levoscoliosis is less common than scoliosis with curvature to the right.
For approximately 80 percent of people who have scoliosis, the condition develops without an apparent cause or reason (idiopathic). Medical conditions, wear and tear, and injury can also cause scoliosis and levoscoliosis.
Levoscoliosis or scoliosis involving a left spinal curve is considered less common than those involving right curvatures.
A 2014 review study found that an estimated 85 to 90 percent of adolescents with scoliosis had right curves.
It also found that levoscoliosis is more associated with conditions such as spinal tumors, growths, and neuromuscular disorders.
Types of scoliosis and levoscoliosis with known causes (non-idiopathic) include:
- Congenital scoliosis: Caused by conditions present at birth that interfere with the development of the spinal bones and configuration.
- Neuromuscular scoliosis: Caused by conditions that cause a loss of muscle control and sensation.
- Degenerative scoliosis: Caused by wear and tear on the bones and joints of the spine that naturally occurs with age.
- Mesenchymal or syndromic scoliosis: Caused by a more significant syndrome or condition that interferes with or limits the connective tissues and joints that stabilize the spine.
Types of scoliosis and levoscoliosis with uncertain or unknown causes include:
- Infantile scoliosis: Develops within the first 2 years of life.
- Juvenile scoliosis: Develops between 3–9 years of age.
- Adolescent scoliosis: By far the most common type of idiopathic scoliosis diagnosed, develops in individuals 11 to 18 years of age.
- Adult scoliosis: Develops in individuals past the age of 19.
Some research shows that scoliosis may have a genetic cause; approximately 30 percent of people with idiopathic scoliosis have a family history of the condition. Many of the medical conditions that can cause scoliosis are genetically inherited.
Currently, researchers do not think lifestyle habits, such as poor posture, inactivity, or diet, play any role in the development of scoliosis, though they may play a role in worsening symptoms.
Levoscoliosis may cause back and chest pain, as well as potential heart problems.
Typically, the severity of the condition depends on the extent of the curve, where it is, and the cause.
Many people, especially younger children and adolescents, develop a mild form of levoscoliosis that does not tend to cause any obvious symptoms other than a slight change in posture and how clothing fits.
Severe scoliosis tends to occur less often, but it can be very painful, and if it is left untreated can cause serious health risks.
In general, levoscoliosis is considered to be a particularly dangerous form of scoliosis because the heart is located in the left half of the body.
Potential complications associated with moderate to severe forms of levoscoliosis that are left untreated include:
- chronic, often disabling back and chest pain
- stress, anxiety, and depression
- lung and breathing problems
- rib deformities and pain
- heart distress and failure
- loss of control or reduced functioning of bladder and bowels
- loss of sensation, pain, or reduced blood flow in arms and legs
How is it diagnosed?
To diagnose levoscoliosis, a doctor will ask a person questions about:
- medical history
- family medical history
- what may have caused the curve to develop, such as an injury
The doctor will then perform a physical exam to assess the alignment of the spine, shoulders, and hips and check for pain, tingling, numbness, and muscle weakness.
A doctor will also ask the individual to bend forward at the waist and let their arms hang to the sides.
Once a doctor suspects levoscoliosis, they will order an X-ray to confirm the condition and determine the extent of the curve.
Other diagnostic tools commonly used to confirm and assess scoliosis include:
- computed tomography (CT) scan
- magnetic resonance imaging (MRI) scan
- spinal radiograph
Most doctors ultimately diagnose levoscoliosis by measuring the angle between the two most misaligned vertebrae on diagnostic images. This is known as the Cobb angle.
A Cobb angle greater than 10 degrees is considered a sign of scoliosis and requires monitoring.
The most effective course of treatment depends on the cause and severity of the scoliosis, as well as the individual's health and age.
Common treatments for scoliosis and levoscoliosis include:
Back or underarm brace
A back brace may prevent worsening of spinal curvature, although it may not be a long-term treatment option.
Wearing a plastic back brace cannot reverse a spinal curve, but it can help prevent curves from worsening in about 80 percent of children. Children with spine curvatures between 25 and 45 degrees may need to wear a back brace.
Most people will need to wear the brace between 16 and 23 hours a day, only taking it off to bathe or exercise.
Once the bones have stopped growing or repairing themselves, a back brace will no longer be useful.
In severe cases, especially when spinal curvatures threaten major organs or are disabling, a spinal fusion may be performed in an attempt to reverse the curve.
In spinal fusion procedures, a surgeon realigns the curved bones and then attaches small pieces of bone tissue along the repaired region. When it heals, it will form a single, straightened bone.
A metal rod may be attached to the spine after surgery to ensure the bone remains straight while healing. Most people can walk the day after surgery and can return to non-strenuous activities in around 4 weeks.
Do exercises work?
The scientific community is conflicted over the value of some therapies, such as chiropractic and massage. However, physiotherapy has offered more promising results.
Founded in 2004, the international Society of Scoliosis Orthopedic Rehabilitation and Treatment (SOSORT) have developed physiotherapy scoliosis-specific exercises (PSSE).
What do the studies say?
Several high-level studies have shown that PSSE can help treat mild to moderate cases of scoliosis, especially when used alongside bracing.
Currently, major North American scoliosis organizations, such as the Scoliosis Research Society (SRS), do not support the use of physiotherapy as part of scoliosis treatment.
The core principles of the program include:
- auto-correction, which involves educating the individual to recognize and actively attempt to readjust spinal curves, often using images or mirrors
- incorporating activities that encourage good posture and strengthen the spine into everyday life
- elongation of the spine
- expansion of the chest wall, usually by standing and stretching the arms out with the palms facing forward for at least 20 seconds
In most instances, people with a minor form of scoliosis do not require treatment, and it is not a sign of a serious underlying medical condition.
However, people who have more severe cases of scoliosis may experience serious complications, such as chronic pain and reduced organ function, if they do not receive treatment. Levoscoliosis is considered especially dangerous given that the heart is on the left side of the body.
For children and adolescents, wearing a back brace can help stop the progression of the curvature; but surgery may be necessary for adults or adolescents with severe spinal curves.