Identifying and treating scoliosis

by Dr. Chris Singh

Scoliosis is defined as a lateral or sideways curvature of the spine. In its most severe form, scoliosis care be a disabling condition. However, most cases of scoliosis tend to be mild. If fact, many people live their entire lives not knowing they had a scoliosis of the spine.

The most common type of scoliosis is called idiopathic scoliosis. This is a fancy way of saying that we don’t know why it occurs.

However, there does seem to be a genetic component, as it tends to run in families. Other less common causes include neuromuscular conditions such as muscular dystrophy and cerebral palsy. Congenital conditions such as birth defects of the spinal bones can also cause scoliosis.

The symptoms of scoliosis may include noticeable physical differences such as uneven shoulders, waist or hips. Asymmetrical shoulder blades are also a common symptom of scoliosis.

As scoliosis progresses and the curvature of the spine worsens, the spine may rotate which will cause the ribs on one side of the body to become more prominent than the other. If this occurs, back pain and difficulty breathing may be present. It is important to note that the first signs of a scoliosis often appear after a growth spurt.

It is important to consult with a doctor if you notice signs of a scoliosis in your child. The doctor will take a detailed history and perform a physical examination. If your doctor suspects a scoliosis, he or she may send you for an x-ray. More sophisticated imaging techniques such as MRI or CT scans are generally reserved for the most severe cases.

The good news is that the majority of people with a scoliosis do not require treatment. Most of the time, all that is needed is for the doctor to monitor the spine for any significant changes in the curvature. Often, children will require check-ups every six months. Generally, scoliosis will stop progressing after bone growth is complete.

In moderate cases of scoliosis in a still growing child, bracing of the spine may be needed. Although bracing will not cure or reverse a scoliosis, it usually will prevent further progression of the curvature. There are two main types of braces used today to treat scoliosis. The first is called a low profile brace. This type of brace is made of plastic-type materials that conforms to a person’s body. It sits under the arms and wraps around the rib cage all the way down to the hips.

The second type is called a Milwaukee brace. This is a full torso brace that has a flat bar in the front and two flat bars in the back. As you can imagine, this type of brace is very uncomfortable to wear. Braces are usually discontinued once bone growth has stopped in the individual.

In severe cases in which bracing has failed, surgery may be considered. The most common type of surgery is called a spinal fusion. This surgery involves permanently connecting two or more spinal vertebrae in order to straighten the spine. Fastening devices such as metal screws, rods, hooks and wires are routinely used in this type of surgery. If surgery is necessary, it is usually postponed until bone growth has stopped.

Other forms of treatment such as physical therapy and chiropractic care may help relieve the discomfort associated with scoliosis. Exercise, stretching and good posture also seem to have a beneficial effect on scoliosis symptoms.

Until next month, drive safely!


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