Scoliosis See all parts of this guide Hide guide parts 1. About scoliosis 2. Causes of scoliosis 3. Diagnosing scoliosis 4. Treating scoliosis in children 5. Treating scoliosis in adults 6.
Possible complications of scoliosis. About scoliosis Scoliosis is the abnormal twisting and curvature of the spine. It is usually first noticed by a change in appearance of the back. Typical signs include: a visibly curved spine one shoulder being higher than the other one shoulder or hip being more prominent than the other clothes not hanging properly a prominent ribcage a difference in leg lengths Back pain is common in adults with scoliosis.
Seeking medical advice If you or your child have signs of scoliosis, make an appointment to see your GP. What causes scoliosis? A small number of cases are caused by other medical conditions, including: cerebral palsy — a condition associated with brain damage muscular dystrophy — a genetic condition that causes muscle weakness Marfan syndrome — a disorder of the connective tissues Rarely, babies can be born with scoliosis, as a result of a problem with the development of the spine in the womb.
It's more common in females than males. Further problems Scoliosis can sometimes lead to further emotional and physical problems. Causes of scoliosis In most cases, the cause of scoliosis is unknown and it cannot usually be prevented. It is not thought to be linked with things such as bad posture, exercise or diet. Known causes In a small number of cases, a cause is identified. Other health conditions Some cases of scoliosis are caused by conditions that affect the nerves and muscles neuromuscular conditions , such as: cerebral palsy — a condition that affects the brain and nerves and occurs during or shortly after birth muscular dystrophy — a genetic condition that causes muscle weakness neurofibromatosis — a genetic condition that causes benign tumours to grow along your nerves Scoliosis can also develop as part of a pattern of symptoms called a syndrome.
Conditions that can cause syndromic scoliosis include: Marfan syndrome — a disorder of the connective tissues inherited by a child from their parents Rett syndrome — a genetic disorder, usually affecting females, which causes severe physical and mental disability These conditions are usually diagnosed at a young age and children with them are often monitored for problems such as scoliosis.
Birth defects In rare cases, babies can be born with scoliosis. Long-term damage In adults, scoliosis can sometimes be caused by gradual deterioration to the parts of the spine. Diagnosing scoliosis Scoliosis can usually be diagnosed after a physical examination of the spine, ribs, hips and shoulders.
Scans The orthopaedic specialist will take an X-ray to confirm the diagnosis of scoliosis. Treating scoliosis in children If your child has scoliosis, their treatment will depend on their age and how severe it is. The main treatment options are: observation casting bracing surgery These are described below. Observation Treatment is not always necessary for very young children because their condition often corrects itself as they grow.
Casting In some cases affecting young children, the spine may need to be guided during growth in an attempt to correct the curve. Bracing If the curve of your child's spine is getting worse, your specialist may recommend they wear a back brace while they are growing.
Surgery If your child has stopped growing and their scoliosis is severe, or other treatments have been unsuccessful, corrective surgery may be recommended. Surgery in children For younger children, generally those under the age of ten, an operation may be carried out to insert growing rods. Surgery in teenagers and young adults In teenagers and young adults whose spine has stopped growing, an operation called a spinal fusion may be carried out. Risks of surgery Spinal fusion surgery is a major operation which, like any surgical procedure carries a risk of complications.
Some of the main risks the spinal fusion procedure include: bleeding — if this is severe your child may need a blood transfusion wound infection — this can usually be treated with antibiotics the implants moving or the grafts failing to fuse properly — additional surgery may be required to correct this in rare cases, damage to the nerves in the spine — this can lead to permanent numbness in the legs, and can sometimes cause paralysis of the legs and loss of control of the bowels and bladder It's important that parents and children understand the risks of spinal fusion surgery so that they can make an informed decision about treatment.
Additional therapies There is no reliable evidence to suggest that other therapies such as osteopathy and chiropractic can be used to correct the curvature of the spine or stop it progressing.
The role of scoliosis specific exercises is currently under investigation. Treating scoliosis in adults Back pain is one of the main problems caused by scoliosis in adults, so treatment is mainly aimed at pain relief. Medication Painkilling medication is usually recommended to help relieve the pain that can be associated with scoliosis. Exercise General strengthening and stretching exercises can improve your general posture and flexibility, and may help control any back pain. Exercises can also help you maintain a healthy weight, which can reduce the strain on your back.
Bracing Braces are not often used to treat scoliosis in adults, although they can provide pain relief in some cases. There are two types of surgery: decompression surgery — if a disc or bone is pressing down on a nerve, it can be removed to reduce the pressure on the nerve spinal fusion surgery — where the position of the spine is improved using metal rods, plates and screws before being fused into place using bone grafts These are major operations and it can take up to a year or more to fully recover from them.
They also carry a risk of potentially serious complications, including: failure to reduce pain — surgery is generally better at relieving pain that radiates to the legs, rather than back pain the implants becoming displaced, broken or loose infection blood clots rarely, damage to the nerves in the spine — in severe cases this can result in permanent leg numbness and the loss of bladder or bowel control Read more about lumbar decompression surgery. Possible complications of scoliosis Physical complications of scoliosis are rare, although serious problems can develop if it's left untreated.
Emotional issues Having a visibly curved spine or wearing a back brace may cause problems related to body image, self-esteem and overall quality of life. Lung and heart problems In particularly severe cases of scoliosis the ribcage can be pushed against the heart and lungs, causing breathing problems and making it difficult for the heart to pump blood around the body.
If you have a mild curve, you'll need to go for regular checkups to be sure it doesn't get bigger. Scoliosis is more likely to get worse while your bones are still growing. So your health care provider will want to keep an eye on you as you grow. If your health care providers think your curve might get worse or cause problems, they'll probably want you to wear a back brace until you finish growing. The brace doesn't make an existing curve go away, but it can stop it from getting worse.
There's no quick fix for scoliosis. Wearing a brace or recovering from surgery takes a while. For some people, this can be tough. If you'd like, your care team can put you in touch with other people who have gone through the same thing or help you find support groups. There are several different types of braces. If you need a brace, the orthopedic specialist will decide on the number of hours you'll wear it each day and night. The brace acts as a holding device that keeps a curve from getting worse.
A brace won't make your spine straight. But if it does its job well, your curve won't get bigger. If you're getting a brace, your care team will work with you to choose the right one. The right brace is the one that works best for the type of curve you have — but it's also the one you're most likely to wear.
So make a list of questions and concerns to discuss with your care team, and let them know all the activities you like to do. Some teens with severe scoliosis need a type of surgery called a spinal fusion. During the operation, an orthopedic surgeon straightens the spine as much as possible and holds it in place with rods and screws. This is performed through the back while the patient lies on his or her stomach.
During this surgery, the spine is straightened with rigid rods, followed by spinal fusion. Spinal fusion involves adding a bone graft to the curved area of the spine, which creates a solid union between two or more vertebrae.
The metal rods attached to the spine ensure that the backbone remains straight while the spinal fusion takes effect. This procedure usually takes several hours in children, but will generally take longer in older adults. With recent advances in technology, most people with idiopathic scoliosis are released within a week of surgery and do not require post-surgical bracing. Most patients are able to return to school or work in two to four weeks post surgery and are able to resume all pre-surgical activities within four to six months.
Anterior approach: The patient lies on his or her side during the surgery. The surgeon makes incisions in the patient's side, deflates the lung and removes a rib in order to reach the spine. Video-assisted thoracoscopic VAT surgery offers enhanced visualization of the spine and is a less invasive surgery than an open procedure.
The anterior spinal approach has several potential advantages: better deformity correction, quicker patient rehabilitation, improved spine mobilization and fusion of fewer segments. The potential disadvantages are that many patients require bracing for several months post surgery, and this approach has a higher risk of morbidity — although VAT has helped to reduce the latter.
Decompressive laminectomy: The laminae roof of the vertebrae are removed to create more space for the nerves. A spinal fusion with or without spinal instrumentation is often recommended when scoliosis and spinal stenosis are present. Various devices like screws or rods may be used to enhance fusion and support unstable areas of the spine.
The use of advanced fluoroscopy X-ray imaging during surgery and endoscopy camera technology has improved the accuracy of incisions and hardware placement, minimizing tissue trauma while enabling a MIS approach. It is important to keep in mind that not all cases can be treated in this manner and a number of factors contribute to the surgical method used.
The benefits of surgery should always be weighed carefully against its risks. Although a large percentage of scoliosis patients benefit from surgery, there is no guarantee that surgery will stop curve progression and symptoms in every individual. The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Register with iGive. Joint Providership.
Scoliosis Scoliosis is an abnormal lateral curvature of the spine. While the degree of curvature is measured on the coronal plane, scoliosis is actually a more complex, three-dimensional problem which involves the following planes: Coronal plane Sagittal plane Axial plane The coronal plane is a vertical plane from head to foot and parallel to the shoulders, dividing the body into anterior front and posterior back sections.
Incidence and Prevalence. Donate Here. See Bracing Treatment for Idiopathic Scoliosis. See Lumbar Spinal Fusion Surgery. Back Pain in Kids and Teens. Lumbar Spinal Fusion Surgery.
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