What is scoliosis?
Scoliosis causes the spine to
curve in the wrong direction. It causes sideways curves, and those are
different from the spine's normal curves.
If you were to look at your spine
from the side, you'd see that it curves out at your neck (cervical spine),
in at your mid-back (thoracic spine), and out again at your low back
(lumbar spine). Your back is supposed to have those
curves.
However, if you look at your spine
from behind, you shouldn't see any curves at all. When there are sideways
curves in the spine from this view, that's scoliosis. The curves can look
like an 'S' or a 'C.'
What causes scoliosis?
Because there are different
types of scoliosis, there are different causes. The types of scoliosis
are:
- Idiopathic Scoliosis: This
is the most common type. 80% of scoliosis cases are idiopathic, which
means "occurring without known cause."
- Congenital Scoliosis: With
congenital scoliosis, there is a malformation of the spine in utero, so
a child is born with this type of scoliosis.
- Neuromuscular Scoliosis:
Children with a neurological system disorder, like muscular dystrophy,
can develop neuromuscular scoliosis. Because they have a weak trunk and
can't support the weight of their body, the spine starts to curve,
generally into a long, c-shaped curve.
- Adult or Degenerative
Scoliosis: Sometimes, scoliosis goes unnoticed-or untreated-during
childhood. In that case, the scoliosis can cause problems later in adult
life. Degenerative, or age-related, changes to the spine can also cause
scoliosis in adults. Osteoporosis, disc degeneration, a spinal
compression fracture, or a combination of these problems can contribute
to the development of adult scoliosis.
Can adults have scoliosis?
Although scoliosis is most
commonly associated with children, adults can develop it, too. In some
cases, they have actually had it their whole lives, but it has gone
unnoticed or untreated until it started to cause pain or other problems.
In other cases, age-related changes in the spine, such as disc
degeneration, lead to scoliosis.
What are some non-surgical ways
to deal with scoliosis?
For children with scoliosis,
there are two main non-surgical options: observation of the curve and
bracing.
The doctor will develop a treatment
plan that considers the patient's age, number of growing years that
remain, curve pattern, curve size, likely rate of curve progression, and
appearance. He or she will then recommend observation or
bracing.
Most young patients with idiopathic
scoliosis will see their doctor every 3 to 4 months so that the doctor can
monitor if the curve is getting worse.
Bracing is the usual treatment for
adolescents with curves greater than 20? and at least two years of growth
remaining. Bracing is used to slow or stop the curve from getting larger
and to improve spinal deformity.
For adults with scoliosis, the
non-surgical treatment options are slightly different. Because bracing
won't help stop the curve in adults and because it usually doesn't control
pain, adults generally do not have to wear braces. Instead, they can try
moist heat, medication for inflammation and pain, and
exercise.
What are the surgical options
for scoliosis?
Doctors recommend surgery for
children if they have progressive scoliotic curves greater than 40?. The
goal of spine surgery for scoliosis is to stop the curve from getting
worse, restore the spine to a more normal alignment and appearance, and
also to address any back pain or heart or lung function problems caused by
the scoliosis.
For scoliosis, spinal fusion using
spinal instrumentation is the most common surgical procedure. Using a
combination of rods, hooks, cables, screws, and cages, the surgeon very
carefully moves the spine back into a more normal alignment. Then the
surgeon puts in a bone graft (usually using bone from the patient's body)
or a biological substance (which will stimulate bone growth) to help the
bones in the spine fuse together over time.
Adults with scoliosis may also have
surgery, but it will be for different reasons. Unlike scoliosis surgery
for children, correcting the curve isn't the most important goal of
surgery. Instead, trying to stop the curve from getting worse later is the
main
goal.
