Scoliosis usually occurs in the thoracic spine and the thoracolumbar segment of the spine between the thoracic and lumbar regions, but, of course, can occur in the lumbar region alone. The thoracic curvature becomes larger and looks like this: The lumbar curvature becomes straighter and looks like this: The scoliosis appears on one side of the spine or in an anterior-posterior direction (commonly known as a hunchback) and takes on a ‘C’ shape, or it appears bilaterally and takes on an ‘S’ shape. C-Shape: C-Shape scoliosis is characterized by the curvature of the spine offset to one side of the spine all in one area, such as the thoracic spine and sometimes the lumbar spine. The left or right C-shaped abnormality is determined by the direction of the curvature, i.e., when the spine curves on the right side, the scoliosis is defined as a right-sided C-shaped spine, and vice versa. S-Shape: S-shaped scoliosis is characterized by at least two arcs that are offset from both sides by the midline of the spine, for example, the upper arc is offset to the right in the thoracic portion of the spine and the lower arc is offset to the left in the lumbar portion of the spine. It is important to note that S-shaped scoliosis highlights one primary curvature, versus another compensatory curvature. Because of the different directions of offset, treatment of this abnormality is more complex and requires more care. Causes of “Hunchback”: Idiopathic Scoliosis “Idiopathic” means that the cause is unknown. We do not know exactly what causes this most common form of scoliosis (80-85%), and it is thought to be related to genetic, hormonal, endocrine, growth and developmental abnormalities, as well as dysfunctions of the neurological balance system. The term “congenital” scoliosis does not refer to an entirely genetic condition, but rather to an abnormality in the shape and structure of the vertebrae that occurs during fetal development: one or more of the vertebral structures are not fully formed or the vertebrae are not segmented properly. This type of scoliosis may be accompanied by other conditions, such as malformations of the heart or kidneys. Congenital scoliosis is associated with genetic factors, as well as a variety of environmental factors such as lack of oxygen or vitamin deficiencies during embryonic development at the time of pregnancy. Neurofibromatosis scoliosis This is caused by the destructive erosion of the spinal vertebrae by a neurofibroma, the underlying cause of which is a neurofibroma. Neuromuscular scoliosis Any condition that involves nerves and muscles can lead to scoliosis, most commonly due to muscle imbalances and weakened muscles. Neuromuscular disorders that commonly cause scoliosis include cerebral palsy, myasthenia gravis, and spinal cord injury. Degenerative scoliosis This type of scoliosis often occurs in older people, especially older women, and is caused by degeneration and aging of the intervertebral discs and osteoporosis of the spine. It is important to note that postural scoliosis is not true scoliosis! The biggest difference between the two is that postural scoliosis can be corrected by the body itself, while true scoliosis cannot be corrected by the body itself.