The Cruved Resulting Scoliosis
By Neurosurgery Singapore
What is Scoliosis?
Scoliosis is an abnormal curvature of the spine. The normal shape of a person’s spine includes a curve at the top of the shoulder and a curve at the lower back. If your spine is curved from side to side or in an “S” or “C” shape, you might have scoliosis.
Therefore these curves can make a person’s shoulders or waist appear uneven. These curves can’t be corrected simply by learning to stand up straight. You can’t cause scoliosis; it does not come from carrying heavy backpacks, participating vigorously in sports, or poor posture.
Most cases of scoliosis are mild, but some spine deformities continue to get more severe as children grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.
What are some symptoms of Scoliosis?
The most common form of scoliosis appears in adolescent. It is known as adolescent idiopathic scoliosis. It can affect children from the age of 10 years.
“Idiopathic” means that there is no known cause. Symptoms can include the fact that:
- the head is slightly off center
- the ribcage is not symmetrical, so the ribs may be at different heights
- one hip is more prominent than the other
- a person’s clothes do not hang properly
- one shoulder, or shoulder blade, is higher than the other
- the person may lean to one side
- uneven leg lengths
In infants, symptoms can include:
- a bulge on one side of the chest
- consistently lying curved to one side (in babies)
- problems with the heart and lungs, leading to shortness of breath and chest pain (in more severe cases)
Some types of scoliosis can cause back pain, but it is not usually very painful. Back pain is not uncommon in older adults with long-standing scoliosis.
If a person does not receive treatment for their scoliosis, problems can arise later in life, such as impaired heart and lung function.
“Scoliosis often appears in children. In most cases, treatment is not needed, as the curve corrects itself with growth. However, based on the degree of curvature and the age of the child, a combination of bracing and physical therapy is often recommended.”
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What types of diagnosis?
A physical exam of your spine is the first step your doctor takes to see if you have scoliosis. Our Spine Specialist may also order some imaging tests to get a closer look at your spine.
Our doctor will observe your back while you stand with your arms at your sides. They’ll check for spine curvature and whether your shoulders and waist area are symmetrical.
Next, our doctor will ask you to bend forward, looking for any curvature in your upper and lower back.
Our Spine Specialist may order to look for scoliosis include:
- X-ray: This is used to create a picture of your spine.
- MRI scan: This test uses radio and magnetic waves to get a detailed picture of bones and the tissue surrounding them.
- CT scan: During this test, X-rays are taken to get a 3-D picture of the body.
- Bone scan: This test detects a radioactive solution injected into your blood that concentrates in areas of increased circulation, highlighting spinal abnormalities.
Possible treatment methods?
Most children with scoliosis have mild curves and probably won’t need treatment with a brace or surgery. Children who have mild scoliosis may need regular checkups to see if there have been changes in the curvature of their spines as they grow.
If your child’s bones are still growing and he or she has moderate scoliosis, our doctor may recommend a brace. Wearing a brace won’t cure scoliosis or reverse the curve, but it usually prevents further progression of the curve.
Most braces are worn day and night. A brace’s effectiveness increases with the number of hours a day it’s worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities.
Braces are discontinued after the bones stop growing. This typically occurs:
- About two years after girls begin to menstruate
- When boys need to shave daily
- When there are no further changes in height
Nonoperative treatment is appropriate for the majority of adults with degenerative scoliosis who don’t have disabling symptoms. Treatments include:
- Periodic observation
- Over-the-counter pain relievers
- Exercises aimed at strengthening the core muscles of the abdomen and back and improving flexibility
- Braces with short-term use of for pain relief (long-term use in adolescents is discouraged because braces can weaken the core muscles)
- Epidurals or nerve block injections for temporary relief of leg pain and other symptoms
Stronger pain medications can also be habit-forming and must be used with caution. If narcotics are needed to control the pain, see a scoliosis surgeon to learn more about the pain generators.
Surgical treatment is reserved for patients who have:
- Failed all reasonable conservative (non-operative) measures.
- Disabling back and/or leg pain and spinal imbalance.
- Severely restricted functional activities and substantially reduced overall quality of life.