Scoliosis is not a disease, but rather it is a term used to describe any abnormal, sideways curvature of the spine. Scoliosis is usually mild and needs no treatment. The curve can bend to the left or to the right. The severity of the curve can vary from very mild and barely noticeable to severe.
Normally the spine is straight, but when scoliosis occurs, the spine may curve in one of the three ways:
- Levoscoliosis – The spine curves the letter C to the left.
- Dextroscoliosis – The spine curves to the right like a mirror image of letter C.
- Double curvature in the spine like the letter S.
Types of Scoliosis:
- Congenital Scoliosis: Present at birth, this is caused by a bone abnormality.
- Neuromuscular Scoliosis: As the name suggests this results due to abnormal nerves or muscles. People with spinal bifida or cerebral palsy are often found with such scoliosis. Some people affected by paralysis may also have a similar condition.
- Degenerative Scoliosis: Resulting from conditions such as osteoporosis (thinning of bones), bone collapse, a previous back surgery or trauma from injury or illness.
- Idiopathic Scoliosis: This is a broad term used for a condition where the cause is unidentifiable. This may even be inherited and is of the most common type.
- Shoulders are different heights – one shoulder blade is more prominent than the other
- Head is not centered directly above the pelvis
- Appearance of a raised, prominent hip
- Rib cages are at different heights
- Uneven waist
- Changes in look or texture of skin overlying the spine
- Leaning of entire body to one side
- Rib prominence when bent over
Bracing is the usual treatment choice for adolescents who have a spinal curve between 25 degrees to 40 degrees — particularly if their bones are still maturing and if they have at least 2 years of growth remaining. The purpose of bracing is to halt progression of the curve. It may provide a temporary correction, but usually the curve will assume its original magnitude when bracing is eliminated.
Those who have curves beyond 40 degrees to 50 degrees are often considered for scoliosis surgery. The goal is to make sure the curve does not get worse, but surgery does not perfectly straighten the spine. During the procedure, metallic implants are utilized to correct some of the curvature and hold it in the correct position until a bone graft, placed at the time of surgery, consolidates and creates a rigid fusion in the area of the curve. Scoliosis surgery usually involves joining the vertebrae together permanently– called spinal fusion.
- Posterior Surgical Approach: A larger incision is made in thoracic portion of the spine. The muscles are moved on the side to expose the bone of the spine. Screws, wires, hooks and rods are used to reduce the curvature of the spine. The surgeon places bone graft around the bones to be fused to get them to grow together and become solid.
- Anterior Surgical Approach: An open incision is made in the thoracolumbar junction (T12 – L1) and removed the ribs (usually from left side). The diaphragm can be released from spine or chest wall to expose the thoracic and spinal vertebral.
- The discs are removed to loosen up the spine.
- Screws, wires, hooks and rods are used to reduce the curvature of the spine. The surgeon places bone graft around the bones to be fused to get them to grow together and become fused.
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