Fourteen-year-old Betsy was really excited about the Valentine's Day dance. It would be her first "real" dance. She and her mom had shopped a long time for the perfect dress before they found it. The dress needed some alterations, and Betsy's mother had a difficult time getting the seams and hem straight. It was almost as if one hip were higher than the other. She thought nothing of it, though, because Betsy was changing so rapidly that it was almost impossible to keep her in clothes that fit. Several weeks after the dance, however, the school nurse called Betsy's parents. She recommended they take her to the doctor because she suspected that Betsy had scoliosis.

Predisposing conditions are those that are developmental or congenital. The following will give you a brief explanation of the most common of these, so you will better understand the terminology if it is used by your physician.

Conditions of structural abnormality have several characteristics. Scoliosis, better known as "curvature of the spine," is one of these. It is more common in females than males. The seriousness of scoliosis is evaluated by degrees. A slight curvature of 10-15 degrees might require surgery and/or bracing. Scoliosis was a serious and relatively common problem a number of years ago, but has become controllable in recent times. Many elementary schools now provide scoliosis screening, so the problem is often recognized early when intervention is most effective. However, it is possible that a small degree of curve can increase in later life, can become painful and may require a medical evaluation by your doctor.

Spondylolisthesis affects approximately five percent of the population, and most of these individuals don't know they have it. The word is so long that the disease sounds frightening. It means that the fifth lumbar vertebra has a forward displacement upon the sacrum, or less commonly, the fourth lumbar vertebra is on the fifth lumbar vertebra. The cause is a loss of bony continuity in the most narrow part of the arch between the lamina and facet joint. This can be diagnosed by X-ray. If it is severe, surgery to fuse the spine may be necessary to stabilize the spine. It is more common for an individual to go through life unaware of the abnormality.

Spina bifida means a forked or separated spine. The arches fail to form over the spinal cord of the developing fetus, leaving no protection between the spine and the cord. It is a serious abnormality in infants, but it can often be corrected surgically. Another term that is frequently used, spina bifida occulta, means a small separation of bone; it is not thought to be a painful, dangerous or unstable condition. If you doctor suddenly tells you that you have spina bifida, and you are totally unaware of any kind of abnormality, he is most likely talking about the latter deformity.

Other anatomical abnormalities occasionally show up on X-ray, such as four lumbar vertebra instead of five, or six instead of five. Neither of these conditions causes problems. It is also possible for a person to have poorly formed vertebrae at birth, but this is rare.

All of these conditions are unusual, but may show up in later years. If you have been healthy all your life and thought that your spine was perfect, it may be a shock to discover that it is not. But even with some abnormalities, you can continue a normal life doing most of the activities you enjoy. The way you do those activities may require some modification, but the change will prevent problems later.