Scoliosis
Scoliosis is an abnormal curvature of the spine (backbone). The spine has a natural frontward and backward curve. In scoliosis, the spine is rotated, creating a lateral curvature.
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What is Scoliosis?
Scoliosis refers to an abnormal curvature to the spine. The spine has a natural frontward and backward curve. In scoliosis, the spine is rotated, creating a lateral curvature.
The angle of the curve can range greatly from small to large. That said, any form of curvature that measures more than 10 degrees on an X-ray is considered scoliosis. Doctors may often describe the curve using the letters “C” or “S”.
The most common form of scoliosis is idiopathic. It is present at birth and can be inherited. Other types include neuromuscular scoliosis and degenerative scoliosis.
In adults, the cause is usually due to degeneration. Most mild cases are treated non-surgically. In severe cases, surgery may be needed if there is nerve compression and restriction of function affecting activities of daily living.
Types of Scoliosis
Idiopathic scoliosis
This is a form of scoliosis without a known cause. In the majority of the diagnosed cases, doctors cannot ascertain the exact reason for the spine curvature.
Neuromuscular scoliosis
This could be caused by a disorder like spina bifida, cerebral palsy, or a spinal cord injury. These conditions can often damage supporting spinal muscles, resulting in your spine not being supported correctly, thus causing your back to curve.
Degenerative scoliosis
This form of scoliosis affects adults and usually develops in the lower back. This is often caused by age-related degeneration of the disks and joints of the spine.
Frequently Asked Questions
What are the symptoms?
The following are some of the more common symptoms that are seen in moderate or severe scoliosis:
- You may start to notice changes with the way you walk. Your hips may start to be misaligned due to the spine twisting or bending sideways too much. This affects a person’s gait and over time, will result in muscular imbalance.
- Experiencing a reduced range of motion. This is often due to the deformity from spinal twisting which can affect the spine’s ability to bend.
- If the spinal rotation is severe, your rib cage can twist and tighten the space available for your lungs. This can result in difficulty in breathing.
- A severe curvature may strain your back muscles, making them prone to painful spasms. In many cases, local inflammation may start to develop around the strained muscles.
What are my treatment options?
Most people with idiopathic scoliosis do not need treatment. However, it is still recommended that you get checked by a doctor about every 6 months. Some ways to treat the condition may include:
- Bracing may be used when the curve measures more than 25° to 30° on an X-ray. Back braces are best suited for people over age 10. However, braces do not work for those with congenital or neuromuscular scoliosis.
- You may require surgery when the curve measures 45° or more on an X-ray and bracing has not worked to slow down the progression of the curve (especially when a person is still growing). After surgery, you may also need to wear a brace for a period of time to maintain the stability of the spine.
How is it diagnosed?
The main ways for diagnosing scoliosis are a thorough physical evaluation and a X-ray exam. Your doctor will use the X-ray to measure the degree of spinal curvature.
Other tests may be conducted to check for lateral curvature, axial rotation, or congenital scoliosis. These include:
- A MRI scan that is able to produce detailed images of organs and structures within the body.
- A CT scan is more detailed than a general X-ray as it uses X-rays that is closely-integrated with computer technology. The scan can produce detailed images of any part of the body, including the bones, muscles and organs.
For scoliosis, early detection is important for successful treatment.
Targeted Procedures
Spinal Fusion
Why choose spinal fusion?
Spinal fusion is a type of spine surgery performed to promote stability at a diseased motion segment. This usually involves removal of the lamina (portion of the vertebrae that covers the spinal cord). Removing the lamina relieves pain and pressure. Subsequently, screws and rods are inserted. Bone grafts are added to the sides of the spine. The grafted bone will then fuse to the spine.
Is it suitable for me?
You may be a candidate for spinal fusion if you have signs and symptoms of spinal instability. These may include pain, weakness or numbness of the hands and feet.
MIS TLIF
The goal of this procedure is to stabilise the spine, minimising low back and leg pain. This procedure stops the motion of the affected disc level by placing screws, rods and bone graft to promote the two vertebrae to become one bone (spinal fusion).
Typically two 2-3 cm incisions are made on either side of the lumbar spine. After the incisions are made, a minimally invasive approach is made down to the vertebral body using dilating tubes. The surgeon then ensures that spinal screws are securely placed into the vertebral body of spine. Live x-ray and live nerve monitoring are used to ensure that the screws are placed accurately.
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