What is
Scoliosis
Scoliosis refers to an abnormal sideways curvature of the spine. A normal human spine has zero (or close to zero) curvature sideways when looking at it from the front, when a person is standing upright in a natural, balanced posture. More than 10 degrees of curvature in this view is the definition of scoliosis. There are different types of scoliosis, which are often evaluated and treated differently:
1) Idiopathic scoliosis: This form is not secondary to another condition. This is the most well-known type that presents most often in adolescence (age 10-17). It affects girls much more than boys, and is passed down in families. It is estimated that approximately 3.5% of children in the USA are affected. There are also rarer forms that present before age 10.
2) Neuromuscular scoliosis: This refers to scoliosis that is secondary to some sort of neuromuscular condition or syndrome. There are too many to mention, but common ones would include cerebral palsy, myelodysplasia, muscular dystrophy, polio, spinal cord injury, etc.
3) Degenerative scoliosis: This is the adult-onset form that occurs secondary to the development of degeneration of the spine and its joints. This is most common after the age of 50.
4) Congenital scoliosis: This is caused by abnormal development of vertebra, present at birth. Sometimes vertebra fail to form normally, or they can fail to segment from each other, leading to abnormal curvature of the spine. This can be noticeable at any age in childhood. Conditions
What are the Symptoms of Scoliosis?
When significant enough, it is associated with uneven appearance of the shoulders and/or hips, uneven appearance of the shoulder blades, or a prominence of the ribs (“rib hump”), often most noticeable when bending over forward. Many patients have no other symptoms, but in advanced cases or when another underlying condition is involved, patients may have a wide variety of problems including back pain, leg numbness/tingling or weakness, bladder symptoms, compromise of heart or lung function, etc. Some patients do not get worsening over time (“stable”), while others develop increasing symptoms or curvature over time (“progressive”).
How do you Screen and Diagnose Scoliosis?
The diagnosis of scoliosis may be made by your child’s school nurse. The nurse generally uses the Adam’s Forward Bending Test, which has the child bending forward at the waist and reaching his or her arms straight outward. Abnormalities such as a protruding rib or an abnormally shaped back may be seen. Scoliosis can also be diagnosed during routine pediatric exams. The physician will examine the spine, hips, shoulders and legs to assess for signs of scoliosis. If scoliosis is suspected, X-rays may be ordered to confirm the diagnosis and determine the severity of the spinal curvature. A child’s scoliosis is determined by the shape, size, direction, location and angle of the curve.
Adult scoliosis is often diagnosed with X-rays taken during a search for the cause of back or leg pain. Scoliosis may also be diagnosed when an X-ray is taken for an unrelated issue and the radiologist notices the scoliosis on the X-ray.
For children, treatment options for scoliosis are based on age, gender and the location and severity of the curve. The curvature is monitored closely and, if necessary, managed with bracing. Bracing does not cure scoliosis, but it may impede further progression of the curve. If the curve advances despite conservative measures or the measurement of the curve is greater than 40° to 50°, surgical correction is often considered.
With adult scoliosis, treatment planning is generally based on severity of pain and functional limits. Because of the malalignment of the spine, pain may arise from the facet joints, sacroiliac joints or from nerve root compression. The pain from these conditions is managed with physical therapy, medication, facet injections, sacroiliac joint injections or epidural steroid injections. If pain persists or physical function is significantly limited, surgery may be considered. Posterior lumbar fusion (PLF), combined with pedicle screws and rods, is used to re-align the spine. Sometimes, anterior lumbar interbody fusion (ALIF) is also done to create a 360° fusion (fusing the front and back portions of the spine). It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.
What are the Treatments for Scoliosis?
With adult scoliosis, treatment planning is generally based on severity of pain and functional limits. Because of the malalignment of the spine, pain may arise from the facet joints, sacroiliac joints or from nerve root compression. The pain from these conditions is managed with physical therapy, medication, facet injections, sacroiliac joint injections or epidural steroid injections. If pain persists or physical function is significantly limited, surgery may be considered. Posterior lumbar fusion (PLF), combined with pedicle screws and rods, is used to re-align the spine. Sometimes, anterior lumbar interbody fusion (ALIF) is also done to create a 360° fusion (fusing the front and back portions of the spine). It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.
Whether you are an adolescent or an adult, the experts at the Scoliosis & Spine Tumor Center at the Texas Back Institute will formulate a customized plan to help correct or slow the progression of scoliosis so you can get back to your life.
The available options for treating and coping successfully with scoliosis have never been greater. The goal of treatment at the Scoliosis & Spine Tumor Center is to provide the most appropriate and least invasive care.
Appropriate treatment depends on a number of factors:
- Severity and rigidity of the curve
- Cause of the scoliosis
- The expected course of the condition patient’s:
- Age
- Overall health
- Medical history
- Tolerance for specific medications, procedures and therapies
Treatment options include:
- Watchful waiting with serial observation of the curve
- Exercise & physical therapy
- Bracing
- Anti-inflammatory medications
- Surgery
Regular exercise, weight management and smoking cessation are almost always recommended.
Request An APPOITMENT
Fell free to contact us with any questions or concern regarding Back/Neck pain.