Scoliosis is an abnormal sideways curvature of the spine. It most often occurs when young people are growing, usually right before puberty. Severe scoliosis can be disabling. Our medical staff at Colorado Spine and Scoliosis in Littleton can help explain the symptoms and causes of scoliosis and help you with diagnosis, treatment and surgery if needed. Dr. Anant Kumar specializes in adult degenerative cervical, thoracic and lumbar spine surgery, pediatric spine surgery, scoliosis, and complex spinal deformity.
According to WebMD, about 2% to 3% of Americans develop scoliosis by age 16. Less than 0.1% have spinal curves measuring greater than 40 degrees, which is when surgery is most likely to be recommended.
A Mayo Clinic article describes the symptoms and causes of scoliosis.
What causes most scoliosis cases is still not known. This is called idiopathic. In fact, for more than 80% of people with scoliosis, the cause is unknown and the majority of those are adolescent girls. The thoracic spine is the most common location for scoliosis. Scoliosis does appear to have hereditary factors because it tends to run in families.
Types of scoliosis and their causes include:
- Congenital scoliosis is caused by an abnormality of the bone, which is there at birth.
- Neuromuscular scoliosis is a result of abnormal nerves or muscles, like spina bifida or cerebral palsy and results in paralysis.
- With degenerative scoliosis, it results from a traumatic bone collapse from a previous major back surgery, an injury or illness, or osteoporosis which is a thinning of the bones.
There are certain risk factors associated with scoliosis including age, sex, and family history. Symptoms usually develop during the growth spurt right before puberty, at ages 9-15. Girls have a higher risk of scoliosis and a higher risk of worsening spine curvature than boys. Scoliosis tends to run in families, although most children with scoliosis have no family history of scoliosis. If you do have a family history of scoliosis it increases your risk for the disease.
Most people who have scoliosis have a mild form but for the more severe cases, it can include some health problems like heart, lung, and back problems. Sometimes the rib cage presses against the lungs and heart. This makes it hard to breathe and harder for the heart to pump. It is more common to see adults who had scoliosis when they were children report chronic back pain.
The symptoms of scoliosis are described in a Mayo Clinic article.
Although most people with scoliosis have mild symptoms, some children’s spinal deformities get more severe as they grow.
An especially severe spinal curve can limit the amount of space within the chest, making it hard for the lungs to function properly.
Visual symptoms include, uneven shoulders, the waistline may be flat on one side, one hip is higher, or one shoulder blade is more prominent. Another visual symptom is the child’s head is not centered over his or her body.
As scoliosis gets worse, the spine may rotate or twist (as well as curving to the side) which makes the ribs stick out farther on one side. So, the ribs are higher on one side when the child bends forward from the waist.
Sometimes the symptoms aren’t really noticed because they appear gradually over time and don’t usually cause pain.
Diagnosis and treatment are important to good health. Children who have mild scoliosis need regular check-ups. Their symptoms are carefully followed by a doctor who uses X-rays to see if their curve is getting worse. The doctor will make measurements from the x-rays to determine how large the curve is. The doctor will check those measurements with x-rays the next time they are seen and compare them to see if the curve is getting worse.
If there are changes in the function of the nerves, the doctor may order other imaging tests of the spine, like an MRI or CT scan so they can look more closely at the bones and nerves of the spine.
In a lot of scoliosis cases there is no treatment needed. But in others, they may wear a brace to stop the curve from worsening and in some severe cases, surgery may be needed to keep scoliosis from worsening and to help straighten the spine.
Braces are often recommended as a treatment choice for adolescents who have a spinal curve between 25 degrees to 40 degrees, especially if they have at least 2 years of growth remaining. The purpose of the brace is to stop the worsening of the curve. Most often it can make the correction, but if the brace is taken off, the curve will most likely return.
If a person has curves beyond 40 degrees to 50 degrees, Surgery is often recommended. The purpose of the surgery is to stop the curve from increasing, but it doesn’t always completely straighten the spine. Surgery requires using metallic implants to correct the curvature and hold it in place until a bone graft creates a rigid fusion in the curve.
Because surgery typically requires spinal fusion or joining the vertebrae together permanently, the spine will stop growing at the point of fusion. For younger children, this may not be the right decision and the doctor may look at another technique. Usually, a brace will be required even after the surgery is done.
Many people live with scoliosis with little or no treatment and without pain, but for others it can cause severe complications. Our medical staff at Colorado Spine and Scoliosis in Littleton can explain the symptoms and causes of scoliosis and help you with diagnosis, treatment, and surgery if necessary. You are in good hands with our doctor. Dr. Anant Kumar who emphasizes a multidisciplinary approach with concentrating on non-operative/conservative care and minimally invasive treatment. He only considers surgery if all conservative options have failed. By evaluating each client on a case by case basis, he chooses the optimal solution for the treatment of his patients. Call our office if you have any concerns or questions about scoliosis.