What is Scoliosis?
Scoliosis is sideways curvature of the spine that generally occurs during the growth spurt right before puberty. The cause of scoliosis is usually unknown with approximately 3% of adults having scoliosis. Most of the time, scoliosis involves a mild spinal curvature but more severe spinal curvature can be disabling. Severe scoliosis may restrict heart and lung function and the ability to perform normal daily living activities. Children are checked regularly by their physicians and schools for spinal curvature. Known patients with scoliosis may have more frequent examinations or X-rays to monitor the spine. For the majority of patients no treatment is needed. Others may require back braces to limit more spinal curvature and surgery may be required for severe scoliosis.
Signs and symptoms of scoliosis include a spine that curves to the left or right when viewed from behind. One shoulder may be higher than the other or the shoulder blade may be more pronounced on one side. Hips may be uneven with one hip higher than the other. More severe scoliosis may involve spinal rotation that can make the ribs more prominent on one side and can limit heart and lung function. Children with scoliosis may have no symptoms or back pain. Adults with scoliosis may have more severe pain from bone wear or numbness and weakness from nerves being pinched. Patients can be self-conscious about their appearance as well. Because scoliosis in childhood is frequently gradual and painless it is not uncommon for it not to be noticed or to be seen first by teachers, coaches and classmates.
Although scoliosis usually begins with a growth spurt before puberty, it is unclear why most patients have scoliosis. It can run in families which appear to indicate hereditary factors. Less common scoliosis types may be caused by cerebral palsy, muscular dystrophy, spinal injuries, spinal infections or spinal birth defects. Risk factors include the age right before puberty, being female, and having a family history of scoliosis. Patients with a greater degree of spinal curvature tend to need more intervention. Once puberty is achieved the scoliosis does not usually progress.
You should contact your physician if you see any curvature of the spine. Your doctor will take a complete history and evaluate the spine with a physical exam looking for curvature. Your nerve function will be evaluated along with and muscle strength and skin sensation. Imaging tests can help your doctor identify issues with the spinal bones, heart, lungs and muscles. X-rays may be used to look spinal curvature or used at intervals to evaluate for worsening of the scoliosis.
Studies that may be used for diagnosis include a computed axial tomography (CAT) scan that uses the electromagnetic energy of X-rays to provide a detailed look at the bony anatomy spine and tissue around it. A magnetic resonance imaging (MRI) uses powerful magnets and radio waves to create a detailed picture of soft tissue of the spine, spinal cord and spinal nerves.
Most children with scoliosis will not require treatment and just need monitoring to make sure the curvature is not worsening over time. With growth occurring and moderate scoliosis, your physician may recommend wearing a back brace which can prevent further progression of spinal curvature. Newer braces are form fitting and made of plastic to hide under clothing. The more the brace is worn the less progression of curvature there should be. A couple of years after puberty the brace does not need to be used.
More severe scoliosis tends to progress over time and surgery may be required to reduce severe spinal curvature or to prevent progression of the scoliosis. Fusing the spinal vertebrae is the most common scoliosis surgery.
- Spinal fusion involves permanently attaching two or more of the spinal vertebrae together using bone grafts with plastic or metal screws and rods. This permanently fuses the spine vertebrae in the attached segments. This also requires general anesthesia and a short hospital stay.
Rod implantation in the back attached to the spinal segments at the ends of the spine curvature can allow the spine to continue growing and can be lengthened every 6 months.
Scoliosis can be successfully treated especially if diagnosed and treated early. The Manhattan Brain and Spine Surgeons are highly trained and skilled in the diagnosis, management, and treatment of Scoliosis. Our neurosurgeons can provide the optimal treatment. Neurosurgery is considered essential by insurances and should be covered with your plan. As out-of-network providers, we will check your benefits for you and let you know what they are so there are no surprises. We use an individualized treatment plan for your concerns to provide a personalized holistic plan of care. If you would like assistance, please feel free to contact us (link to contact page) or call our office (link to phone number).