Symptoms of scoliosis may include uneven shoulders and/or hip and a prominence of one shoulder blade over the other, and protruding ribs. Advanced scoliosis can cause back pain and difficulty breathing.
The spine is a curved structure. This helps with weight-bearing, balance and shock absorption. Scoliosis is a three-dimensional, abnormal curvature of the spine often affecting the thoracic and lumbar regions. This condition may be present during adolescence or as an adult.[/tab] [tab title="Treatments"]For children, treatment options are based on age, gender and the location and severity of the curvature. The curve is monitored closely, sometimes managed with bracing and surgical correction is often considered. With adults, treatment is generally based on pain severity and functional limits.[/tab] [/tabs]
Full Description of Scoliosis
The spine is a curved structure. This helps with weight-bearing, balance and shock absorption. Scoliosis is a three-dimensional, abnormal curvature of the spine often affecting the thoracic and lumbar spinal regions. Scoliosis may be present during adolescence or as an adult. Adult scoliosis is most commonly due to degeneration of joints in the spine. The cause of adolescent scoliosis is not completely known. Symptoms of scoliosis may include uneven shoulders and/or hip and a prominence of one shoulder blade over the other, and protruding ribs. Advanced scoliosis can cause back pain and difficulty breathing.
Screening and Diagnosis for 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.
Treatments for Scoliosis
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 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 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:
- Overall health
- Medical history
- Tolerance for specific medications, procedures and therapies
Treatment options include:
- Watchful waiting
- Exercise & physical therapy
- Anti-inflammatory medications
Regular exercise, weight management and smoking cessation are almost always recommended.
What is Scoliosis?
Scoliosis is the presence of abnormal sideways (lateral) curves and longitudinal rotations of the spine. The condition – not a disease – can be accompanied by back pain, muscle tightness and fatigue, along with restricted lung capacity and possible neurological symptoms such as nerve pain, weakness, numbness and tingling.
Scoliosis has three general causes:
- Congenital (present at birth) scoliosis is due to a problem with the formation of the spine bones (vertebrae) or fused ribs during development in the womb.
- Neuromuscular scoliosis is caused by problems such as poor muscle control or muscle weakness, or paralysis due to diseases such as cerebral palsy, muscular dystrophy, spina bifida and polio.
- Idiopathic scoliosis is scoliosis of unknown cause. It appears in a previously straight spine.
Idiopathic scoliosis in adolescents is the most common type of scoliosis. Some people may be prone to a curving of the spine, and most cases occur in girls.
Scoliosis is typically diagnosed during a physical exam, which includes evaluation of posture, shoulder balance and leg lengths. A forward bending test helps the physician define the magnitude and flexibility of the curve. Other tests for scoliosis may include:
- Measure with a scoliometer (a device for measuring the curvature of the spine)
- Spine X-ray
- MRI (if exam reveals neurologic changes or if there is something unusual in the X-ray)
If the curve measures more than 10 degrees, it is considered to be a true scoliotic curve
Surgical Intervention for Scoliosis
In cases where the curvature is severe or does not respond to bracing, surgery may be recommended. At Texas Health Plano’s Scoliosis & Spine Tumor Center, experienced surgeons on the medical staff perform surgery using the most appropriate, innovative and least invasive spine surgery techniques. Less invasive surgery offers more cosmetically acceptable scars, a shorter hospital stay and a quicker recovery.
The medical director of the center, Isador Lieberman, M.D., is internationally recognized for advancing the use of minimally invasive spinal surgery techniques to treat scoliosis. Rejesh G. Arakal, M.D. also leads the team of surgeons at Texas Health Plano who are supported by a specialized operating room team.
Surgery for scoliosis involves correcting and balancing the curve and fusing the bones in the curve together. The bones are held in place with one or two metal rods held down with hooks and screws until the bones knit themselves solid.
Rehabilitation for surgical patients is designed to help them get back to their lives as quickly as possible. With some of the most experienced and qualified therapists in the area, advanced facilities and personalized, one-on-one therapy sessions, Rehabilitation Services at Texas Health Plano provides a positive environment for meeting rehabilitation goals.