What is scoliosis?
Scoliosis is a three-dimensional deformity of the spine involving lateral curvature, rotation of the vertebrae, and changes in the normal front-to-back curves of the spine. It is not simply a sideways bend — it is a complex structural problem that affects the entire spinal column.
In adolescents the cause is most often unknown (idiopathic), occurring during periods of rapid growth. In adults, scoliosis may be a progression of adolescent scoliosis or may develop de novo from degenerative changes in the discs and facet joints. Congenital scoliosis occurs when vertebrae form abnormally before birth.
Dr. Enguidanos has dedicated his career to treating the full spectrum of spinal deformity — from mild curves managed with observation to severe multilevel reconstructions requiring complex surgical correction. His fellowship training at the University of Colorado under Dr. Thomas Lowe, the former president of the Scoliosis Research Society, gives him one of the deepest deformity training backgrounds in the region.
Common symptoms.
- Uneven shoulders — one shoulder blade more prominent than the other
- Uneven waist or hips — one side higher or more prominent
- One side of the rib cage appears higher when bending forward
- Back pain, especially in the lower back or mid-back
- Fatigue from the muscular effort required to maintain posture
- Reduced height over time in adults with progressive curves
- Shortness of breath in severe cases where the rib cage compresses the lungs
- Leg pain or numbness when stenosis accompanies the deformity
What causes it.
- Idiopathic — no known cause, accounts for 80% of adolescent cases
- Degenerative — disc and facet joint degeneration in adults over 40
- Congenital — abnormal vertebral formation before birth
- Neuromuscular — associated with cerebral palsy, muscular dystrophy, or spinal cord injury
- Post-surgical — deformity developing after prior spine surgery
- Osteoporosis — bone loss leading to vertebral compression and collapse
When to call us.
You should seek evaluation if your curve is progressing on serial imaging, if you have significant pain that is not responding to conservative treatment, if you notice worsening posture or height loss, or if you have difficulty standing upright for extended periods.
For adolescents, a curve over 25 degrees warrants monitoring. Over 40 to 45 degrees in a growing child, surgery is generally considered. For adults, the threshold is more individualized — the impact on function and quality of life matters as much as the degree of curvature.
If you have been told your curve is too severe to treat, or if prior surgery has not corrected your deformity, call Dr. Enguidanos's office. These are exactly the cases his practice is built for.