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Viewed from posterior to anterior, the human spine should be straight. Any frontal plane curve seen from this view is described as a scoliosis. Therefore, by definition, scoliosis is a lateral flexion deformity of the spine. If one scoliotic curve is present, it is known as a C-curve. If two curves are present, it is known as an S-curve. And if three curves are present, it is known as a double S-curve (Images 1A–1C). When naming a scoliotic curve, it is named for the side of convexity. For example, the curve seen in Image 1A is a right lumbar C-scoliosis; Image 1B demonstrates a right lumbar, left thoracic S-scoliosis; and Image 1C shows a right lumbar, left thoracic, and right cervicothoracic double S-scoliosis. Further, when a scoliotic curve occurs in the frontal plane, there is also a concomitant transverse plane rotation to the curve. In the lumbar spine, lateral flexion to one side is accompanied by rotation to the opposite side (likely due to the locked-short transversospinalis musculature on the side of concavity). The right C-curve seen in Image 1A comprises lateral flexion to the left, but rotation to the right (rotation is always named for where the anterior aspect of the vertebral body orients). One complication of this is that the spinous processes rotate into the concavity so that the degree of the scoliotic curve is usually greater than what is appreciated by visualizing or palpating the spinous processes. To fully see the degree of a lumbar scoliotic curve, an X-ray is needed. 70 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 8 S C O L I O S I S By Joseph E. Muscolino, DC C L I N I C A L O R T H O P E D I C M A N U A L T H E R A P Y T R E A T M E N T

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