Scoliosis is a common condition and you have probably heard the term used. It is a diagnosis when there is an abnormal curvature in the spine when looking at it in the frontal plane. The curvature is accompanied by twisting of the spine as well. If you view the spine from the front or back, it usually appears straight. But when you view it from the front or back and see a curvature, that’s when we use the term scoliosis. The spine has natural curves when looking at it from the side. These curves help maintain your posture, alignment, and keep your head in a neutral position above your pelvis.
There are several types of scoliosis and depending on the type, there are different treatments and ways to treat and manage this condition.
Scoliosis can be managed both non-operatively and operatively and depends on the type. Scoliosis can almost be completely corrected if necessary. The goals of treatment are to halt progression of the curvature and to keep the spine balanced meaning the head is centered above the pelvis when looking at the spine in both the frontal view and side view.
This scoliosis is the result of abnormal development in the spine, in the earliest stages of development, week three to 6 of pregnancy. The vertebrae may fail to separate completely and act as a tether allowing growth to occur on one side of the spine but not on the other. Therefore a curve may form.
There is no known cause for this type of scoliosis—it occurs for no determined reason although it has a strong genetic component. This will likely be identified in adolescence and followed with x-rays. Treatments include observation, brace treatment, and surgery. This all depends on the degree of curvature and potential for progression. Surgical discussion is often discussed at 50 degrees or more but once again depends on the patient and risk of progression.
This type of scoliosis is diagnosed in patients with underlying neurologic disorders such as children with cerebral palsy or patients with a spinal cord injury. These disorders weaken the truncal musculature that helps stabilize the spine. This can lead to scoliosis that appears as a long C-shaped curve. Spinal fusion can be performed to halt progression and to improve upright posture.
Iatrogenic Flatback Deformity & Scoliosis
This type of scoliosis may develop after surgical procedures. This can be seen in adults who have had scoliosis surgery as an adolescent as spinal implants in the past were not as refined as current techniques. Treatment for iatrogenic deformity and scoliosis varies but often requires surgery for correction of alignment and for pain reduction.
Degenerative Scoliosis occurs throughout the natural aging process. As we get older, our disk and joints wear out and there is less stability in the spine. Also as discs degenerate, they may do so in an asymmetric fashion with one side losing height more so than the other causing and angulation of the disc. This can cause a curvature in the spine. If the aging and natural wear and tear process is the cause of scoliosis, it’s classified as degenerative. Often the curvature can cause back pain but it is also associated with stenosis and pain due to nerve compression. Surgical treatment for this ranges but includes minimally invasive techniques to decompress the nerves and realign the spine.
Do you think you may have scoliosis? Contact us, we can help.