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Scoliosis

Scoliosis can be defined as the sideways curvature of the spine that mostly occurs during the growth spurt right before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is yet unknown to the medical fraternity. Most cases of scoliosis are mild, but in some children, deformities are formed that continue to get more severe as children grow. Severe scoliosis can be disabling. An especially severe spinal curvature can reduce the amount of space within the chest, making it difficult for the lungs to function properly.

Children suffering from mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse gradually. In many cases, a treatment is not necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.

Scoliosis is a lateral (bending toward the side) curvature in the normally straight vertical line of the spine. When viewed from a side, the spine shows a mild roundness in the upper back and shows a degree of swayback (inward curvature) in the lower back. When a person with a normal spine is viewed from the front or back, the spine appears to be straight. When a person with scoliosis is viewed from the front or back, the spine appears to be curved.

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What is the cause of Scoliosis?

There are many types and causes of scoliosis, including:

• Congenital scoliosis is caused by a bone abnormality present at birth.
• Neuromuscular scoliosis is caused due to abnormal muscles or nerves. Frequently seen in people with spina bifida or cerebral palsy or in those with various conditions that are accompanied by, or result in, paralysis.
• Degenerative scoliosis may be caused as a result of traumatic (from an injury or illness) bone collapse, previous major back surgery, or osteoporosis (thinning of the bones).
• Idiopathic scoliosis, is the most common type of scoliosis. Idiopathic scoliosis has no specific identifiable cause. Scientists have derived many theories but none have been found to be conclusive. There is, however, a strong evidence that idiopathic scoliosis is inherited.

Who Gets Scoliosis?

Nearly 2% to 3% of Americans at age 16 have scoliosis. Less than 0.1% have spinal curves measuring greater than 40 degrees, which is when surgery may need to be considered seriously. Overall, girls are more likely to be affected than boys. Idiopathic scoliosis is most commonly a condition of adolescence affecting ages 10 through 16. Idiopathic scoliosis may progress during the "growth spurt" years, but usually will not progress during adulthood.

How Is Scoliosis Diagnosed?

Most scoliosis curves can be detected on school screening exams, by a pediatrician or family doctor, or a parent. Some clues that a child may have scoliosis include uneven shoulders, a prominent shoulder blade, uneven waist, or leaning to either side. The diagnosis of scoliosis and the determination of the type of scoliosis are then made by a careful bone exam and an X-ray to evaluate the magnitude of the curve.

What is the treatment for scoliosis?

The treatment of scoliosis is based on the severity of the curve and the chances of the curve worsening. Certain types of scoliosis have a greater chance of getting worse, so the type of scoliosis also helps to determine the right kind of treatment. There are three main categories of treatment: observation, bracing, and surgery. Functional scoliosis is caused by an abnormality in any other part the body. This type of scoliosis is cured by treating the abnormality, such as a difference in leg length. A small wedge can be placed in the shoe to help even out the leg length and prevent the spine from curving. There is no direct treatment of the spine because the spine is normal in these people. Neuromuscular scoliosis is caused due to an abnormal development of the bones of the spine. It has higher chances of getting worse. Observation and bracing do not normally work well for these people. A good number of these patients need surgery to stop the curve from getting worse. Treatment of idiopathic scoliosis is based on the age at which it develops.

In a majority of cases, infantile idiopathic scoliosis improves gradually without treatment. Juvenile idiopathic scoliosis is at the highest risk of worsening among all idiopathic types of scoliosis. Braces can be tried early if the curve is not very severe. They may prevent the curve from getting worse until the person stops growing. Since the curve starts early in these people, and they have a lot of time left to grow, there is a higher chance for needing more aggressive treatment or surgery

Adolescent idiopathic scoliosis is the most common form of scoliosis. If the curve is small when diagnosed initially, it can be observed and followed with routine X-rays and measurements. If the curve stays below 25 degrees, no other treatment is needed. The patient may see the doctor every three to four months to check whether the curve is worsening. Additional X-rays may be repeated each year to obtain new measurements and check for progression of the curve. If the curve is between 25-40 degrees and you are still growing, a brace may be recommended. Bracing is not recommended for people who have retained the age where they stop growing. If the curve is greater than 40 degrees, then surgery may be recommended.

Scoliosis is not typically associated with back pain. If a person suffers from back pain, the symptoms can be mitigated with physical therapy, massage, and exercises. These can strengthen the muscles of the back. They are not, however, a cure for scoliosis and will not be able to correct the abnormal curve. There are several different types of braces available for scoliosis. Some need to be worn nearly 24 hours a day and are removed only for bathing. Others can be worn only at night. The ability of a brace to work depends on the person following the instructions from the doctor and wearing the brace as directed. Braces are not designed to correct the curve. They are used to help slow or stop the curve from getting worse.

If the curve stays below 40 degrees until the person is finished growing, it is not likely to get worse later in life. However, if the curve is greater than 40 degrees, it is likely to continue to get worse by 1-2 degrees each year for the rest of the person's life. If this is not prevented, the person could eventually be at risk for heart or lung problems. The goals of surgery for scoliosis are correcting and stabilizing the curve, reducing pain, and restoring a more normal curve and appearance to the spinal column. A large number of hospitals in India offer the best possible care. Spine and Neuro Surgery hospital in Nagpur is renowned for its efficient surgeons and medical staff. Spine&Neurosurgery Hospitals in India are equipped with highly sophisticated infrastructure to process the best treatment plan for scoliosis.

A large number of people have a positive result from surgery but like other surgeries, spinal surgery also carries some risks. Potential complications can be relatively minor, such as an infection at the operation site, to the more serious like permanent damage to the spinal nerves. Before choosing a spinal surgery, the surgeon will discuss the possible risks and benefits. It is important to choose the right surgeon. Spine and Neurosurgery Hospitals in India, especially in metropolitan cities like Delhi and Nagpur, provide promising treatment for scoliosis problems. Also the major boost factor is the lesser price. The overall expenses of treatment in India may cost as low as 25 % of what one may have to incur in the western countries, with the same excellence and efficiency in treatment.

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