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Scoliosis

 

What is Scoliosis?

 

The term scoliosis simply means a lateral deviation of the spine.

 

What are the types of Scoliosis?

 

Scoliosis can be classified into different types, depending on the cause. 

Types of scoliosis include the following:

  • Idiopathic Scoliosis
  • Congenital
  • Neuromuscular
  • Degenerative

Idiopathic scoliosis is a curvature of the spine that doesn’t appear to be due to any other medical condition. Current research suggests that it is mainly genetic in nature. In children that present under the age of 6 it is called early onset. When it occurs in the very young it can sometimes progress and be a serious disorder. It is most common in teenagers and is usually a cosmetic issue, where some patients may be bothered by the appearance of their spine, shoulder asymmetry or pelvic obliquity. The condition can be painful in approximately 10% of cases.

 

Some patients may be born with an abnormality of  the bones (vertebrae) within the spine. As the patients grow the spine may become progressively curved. This is known as congenital scoliosis. Some patients may have an underlying disorder that is associated with scoliosis such as muscle weakness or imbalance.

 

How is the back assessed?

 

The spinal surgeon will take a history to ascertain if there is an underlying cause for the scoliosis and will carry out a clinical examination to the assess of curvature, the cause and to see if the nerves are affected.

 

X-rays

 

X-rays are useful to assess the degree of curvature within the spine. They may also show a cause for the scoliosis.

 

MRI Scan

 

Following appropriate assessment by the spinal specialist further investigations may be required. MRI scans are commonly used to investigate the cause of the scoliosis and to exclude any neurological conditions that may have to be addressed before considering scoliosis surgery. Other tests such as X-rays or CT scans may also be used.

 

What treatment do I need?

 

Monitoring

 

Depending on the degree of scoliosis and the cause, your surgeon may elect to monitor the curve within the spine. This will require regular review within the outpatient clinic as well as possible further X-rays.

 

Bracing

 

 Bracing can be considered in certain cases, these include:

 

  • A curve that is moderate in size (25 to 40 degrees)
  • A curve that is progressive (has increased by more than 5 degrees)
  • A significant patient growth is still remaining

Several research studies show that bracing for scoliosis can keep the spinal curve from growing large enough to require surgery.

The curve will most likely get smaller as it is being held in the brace.  In some cases, the curve stays smaller after bracing treatment.

There are some cases, however, where the curve continues to grow even though a brace is worn.

 

Surgery

 

Certain patients may require surgery on their spine to either prevent further progression of the curve, or to reduce the curve within the spine.