Your spine naturally curves vertically to help distribute body weight and to reduce the stress and pressure on any single region of your back. This natural curve resembles an S shape.
Scoliosis is a condition that causes the spine to curve to the left, the right, or both, resulting in a sideways S or C curve. Up to 2-3% of Americans — 6-9 million people — have scoliosis. But while it can be found in people of all ages, it’s most common in children and adolescents, especially during growth spurts.
At Apex Spine and Neurosurgery, with offices in Roswell, Alpharetta, and Bethlehem, Georgia, our expert team of neurosurgeons specializes in spinal deformities, including degenerative scoliosis. Most cases are relatively mild, but if scoliosis is severe or left untreated, it may become disabling.
We put together this guide so you’ll understand the basics of scoliosis and how we can treat it effectively.
Scoliosis can be diagnosed at any age, but the most common onset occurs between 11-18 years old, and it’s the most common spinal deformity in school-age children, primarily girls.
There are various types of scoliosis, but the two primary types are idiopathic and degenerative.
Idiopathic means there’s no identifiable cause. It’s the most common form of the condition, accounting for 80% of all pediatric cases. The most common is adolescent idiopathic scoliosis (AIS), which affects young people ages 11-18, and accounts for most cases, with girls experiencing it more than boys by 10:1.
Degenerative scoliosis occurs because of asymmetrical disc degeneration over time. It tends to affect the lumbar spine, and is generally milder than idiopathic scoliosis. It’s also fairly common, affecting roughly 38% of the population, including up to two-thirds of those 60 and older.
People diagnosed with degenerative scoliosis may experience problems standing fully upright and have back pain, including sciatica, which is pain and weakness that radiates from your lumbar spine down through your buttock into your leg.
Many cases of adult scoliosis don’t require treatment, and the doctor may suggest waiting to see if your curvature progresses over time. In the meantime, you should eat a healthy diet, exercise regularly, avoid smoking, and be attentive to your posture, your gait, and your lifting technique. These preventive measures can help keep your back as healthy as possible.
If scoliosis is left untreated, especially if the spinal curvature is large (40-50 degrees or more), you can develop a number of structural and functional problems, including:
- Spinal instability, leading to herniated discs
- Ribs sticking out to the side
- A humpback
- A limp from the discrepancy in leg length
- Nerve damage or radiating pain
- Difficulty sitting, standing, or walking
- Spinal rigidity
Heart and lung issues may develop over time because of the reduced area in the chest for lungs to expand.
Diagnosing your scoliosis
When you come in to see us for suspected scoliosis, we perform a physical exam, observing your back while you stand with your arms at your sides. We assess whether your spine is curved and if your shoulders and waist are symmetrical. We’ll ask you to you bend forward to see if there’s curvature in your upper and lower back.
We may order some imaging tests to visualize your spine, including:
- X-rays: show the spinal bone structure
- MRI scan: uses radio and magnetic waves to get a detailed picture of bones and surrounding tissue
- CT scan: takes X-rays at a variety of angles and compiles a 3D picture of the body
These images allow us to determine the exact curvature of your spine.
The primary scoliosis treatment options in children are bracing and surgery.
According to the AANS, braces are only effective if the patient is still growing and their curvature is greater than 25-40 degrees, especially if the condition is caught early on. Braces don’t straighten the spine, but they do prevent the curvature from becoming worse.
Patients need to wear the brace for 16-23 hours a day until they stop growing, with the effectiveness increasing with the number of hours worn. Most doctors recommend patients wear the brace until they reach adolescence.
Usually reserved for patients who have curvatures greater than 40 degrees, surgery can also be an option if you feel the curvature is causing undue discomfort or interrupting your daily life.
The standard surgical procedure is a spinal fusion. Our surgeon fuses the vertebrae together using a bone graft (or a bone-like material), rods, and screws. The rods keep the spine straight, and the screws hold the rods in place. The rods can be adjusted as a child grows, and eventually, the graft and the vertebrae fuse into a single bone.
If you have an abnormal spinal curvature, or your child does, come in to see our spine specialists to get the proper treatment. Give Apex Spine and Neurosurgery a call at any of our offices to set up a consultation, or book online today.