Scoliosis is a spinal condition that causes the spine to curve sideways. The condition typically presents in childhood, and symptoms generally begin during the growth spurt that most children have just before they enter puberty. The condition may also develop in later adulthood. While some cases are mild, severe scoliosis can be painful and debilitating, and surgical treatment may be necessary.
What Are the Major Risk Factors for Scoliosis?
While mild scoliosis is equally prevalent in both girls and boys, girls have an elevated risk of serious curvatures that could require surgical intervention. A family history of scoliosis also increases a child’s risk of developing this condition.
What Are the Common Symptoms of Scoliosis?
In children and young adults with scoliosis, symptoms typically include having uneven hips or having one shoulder that is higher than the other. The child’s ribs may protrude, and his or her arms may not hang down straight on the body when he or she is standing straight.
For adults, symptoms of scoliosis may start with back pain, a noticeable loss of height, and difficulty standing up straight. Patients may also have shortness of breath, fatigue, walking difficulties, bone spurs, and a bump in the lower back. They may experience numbness, tingling sensations, and pain in the legs.
How is Scoliosis Diagnosed?
Evaluations for scoliosis are normally handled by a spine doctor, sometimes known as an orthopedist or an orthopedic surgeon. These doctors are specialists in the musculoskeletal system and have the experience necessary to provide accurate diagnoses and advanced treatment.
When you arrive for an initial assessment, you’ll be asked to complete a health history form. This form will ask you about any medications you take and any previous surgeries you have had. It will also ask about your personal and family history of orthopedic conditions, cardiovascular disease, and other medical conditions.
The doctor will review the form with you and ask you questions about your symptoms. He or she may ask how long your symptoms have occurred, whether you’ve experienced any pain, and how the symptoms affect your daily life. You will also be asked about any recent changes you’ve noticed in your height, posture, or joints and about the location and severity of any pain. Tell your clinician about any treatments you have tried in the past and if anything has improved your symptoms.
Next, the clinician will guide you through a brief physical examination. This exam should not hurt, and the doctor will want to know if you experience any discomfort. First, the doctor will visually inspect the alignment of the shoulders, hips, and limbs to check for asymmetry. He or she may also wish to examine the ribs to see whether they protrude. Next, the physician will gently palpate (touch) the spinal column to assess the degree of any curvature. The range of motion, sensation, reflexes, and gait may also be evaluated.
To assist the doctor in making a diagnosis, you may be asked to have imaging studies such as x-rays, CT scans, or MRI scans. These scans can provide a detailed look at any curve that may be present, allowing the orthopedist to craft an effective and personalized treatment plan.
What Will My Doctor Consider When Making Treatment Recommendations?
To guide your treatment, your orthopedist will assess the severity, shape, and location of your spinal curvature. Larger curves, double (S-shaped) curves, and those located in the central (thoracic) part of the spine may need more urgent and aggressive treatment. The doctor will also consider your personal risk factors and how likely it is that your scoliosis may worsen.
What Non-Surgical Treatment Options Are Available?
For mild to moderate scoliosis, the first treatment that is normally recommended is the use of a brace. While the brace can’t correct the spinal curvature, it is often effective in preventing the progression of the curvature. Generally, the braces worn for this condition are made of a contoured, close-fitting plastic that gently hugs the body. The brace goes under the arms and cradles the ribs, lower back, and hips. It is nearly invisible under clothing, allowing patients to have confidence when wearing it out of the house.
If your doctor recommends a brace, he or she will tell you how long you need to wear it. Typically, most clinicians recommend that patients wear the brace during the day and at night. It can be removed for bathing and physical activity.
What Surgical Interventions Are Available?
For severe cases of scoliosis, non-surgical treatments may be ineffective, and doctors may need to perform surgery. At our Miami office, our orthopedists are skilled in several surgical options, and we explain all of these to patients.
One of the most common surgical procedures to correct scoliosis is a spinal fusion procedure. This procedure connects at least two spinal bones to prevent them from moving independently. A material similar to bone will be placed in this area, and metal rods or screws hold the affected area in the proper alignment while the bones and bone-like material connect.
Sometimes, surgeons may opt to insert an adjustable rod. This type of rod is attached to the top and bottom of the curve in the patient’s spine, and it can be lengthened as needed, normally every six months. This procedure is usually done on children or young adults who may still be growing.