Spinal Deformities | Scoliosis

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Spinal deformity is an abnormal alignment or curve of the vertebral column.

Scoliosis is where the spine twists and curves to the side. It most often starts in children from 10 to 15 although it can affect anyone from babies to adults. The condition may not need treatment if it is mild, however more severe cases can cause breathing difficulties and heart problems.

Kyphosis is an excessive outward curvature of the spine leading to hunching of the back. It is commonly due to compression fractures caused by osteoporosis.

Lordosis, also called swayback, causes a concave lower back, thrusting the hips forward and giving a backward-leaning appearance.

Symptoms of spinal deformities include:

  • A visible curvature to the spine
  • Leaning to one side
  • Uneven shoulders
  • One hip higher than the other or a shoulder sticking out
  • Clothes not fitting properly
  • Back pain, more commonly in adult scoliosis
  • As the condition worsens it may cause the spine to twist causing the ribs on one side of the body to stick out more than the other

Around eight out of 10 cases of scoliosis have no known cause. This is referred to as adolescant idiopathic scoliosis (the most common type).

Congenital scoliosis is present from birth and is due to the bones of the spine failing to form properly in the womb.

Neuromuscular scoliosis is the result of an underlying nerve or muscular condition such as muscular dystrophy or cerebral palsy.

Some people may have a genetic predisposition to the condition as it sometimes runs in families.

Less commonly it may be the result of degeneration of the spine due to ageing or injuries or infections of the spine.

Your doctor will carry out a physical examination and may check for abnormal reflexes, muscle weakness or numbness. If scoliosis is suspected you will be referred for an X-ray.

This will check whether the spine is curved and, if so, how severe the curvature is. An MRI scan may be recommended to rule out any underlying condition that might cause the scoliosis, or to ensure that there is no contra indications to carrying out any operative intervention.

Many people with spinal deformities won’t require surgery.

In the case of babies and small children the curve may improve as they grow so the normal course of treatment is likely to include:

  • Monitoring of the condition with regular examinations and X-rays. This is important not only to check whether the scoliosis is worsening but also because there is a small risk that organs can become cramped which may restrict their growth.
  • Wearing a cast around the back may help to straighten the spine of babies and toddlers. The cast is worn continuously and cannot be removed, although it is changed every few months as they grow.
  • Back braces can prevent the curvature from becoming worse although they cannot correct an existing curve. They are custom-made from rigid plastic and need to be worn 23 hours a day. They are normally only removed for baths, showers, swimming and certain sports. A back brace can be worn as long as the child is growing.
  • Regular exercise to improve muscle strength and flexibility, and reduce back pain.
  • Surgical procedures are normally only recommended in children if the scoliosis is worsening despite other treatments or if they have stopped growing and the scoliosis is severe. Among the surgical procedures that may be offered are:
    • Surgery to insert special rods along the spine to stop the curve worsening as the spine grows. This is normally only offered to children under 10. Every few months the child will need to see a specialist to have the rods lengthened. This is done using a remote control that activates magnets inside the rods and does not require any incisions. When the child has finished growing the rods can be removed and a final surgical procedure carried out to straighten the spine.
    • Spinal fusion involves straightening the spine using metal rods, screws, hooks and sections of bone taken from elsewhere in your body, normally your hip. These remain in the body permanently. The procedure is only offered to people who have stopped growing. Sometimes a back brace is necessary after surgery to protect the back while it heals.

Many people with spinal deformities won’t require surgery.

In adults, scoliosis often causes back pain so a treatment plan might include:

  • Medication for pain relief, normally anti-inflammatories.
  • Regular exercise to strengthen and stretch the back. A physiotherapist may recommend specific exercises to relieve pain although they will not help to improve the curvature of the spine.
  • Spinal injections of steroids and local anaesthetic which can help to relieve pain in the short-term but will not address the underlying cause.
  • Back braces are normally only used as a temporary support to ease pain or in adults who are not well enough to undergo surgery.
  • Surgical procedures may be recommended if the curve in your spine is worsening or if there is severe pain that other treatments have not helped. Among the surgery that may be offered are:
    • Laminectomy: This removes a section of bone in your vertebra to relieve pressure on the nearby nerve.
    • Discectomy: A section of disc between the vertebrae is removed to relieve pressure on the nearby nerve.
    • Spinal fusion: Two or more vertebrae are joined together to straighten and stabilise the spine.

A combination of these different procedures may provide the best results.

Scoliosis cannot be prevented and isn’t believed to be linked to bad posture, exercise or diet.

Spinal Deformities

Spinal deformity is an abnormal alignment or curve of the vertebral column.

Scoliosis is where the spine twists and curves to the side. It most often starts in children from 10 to 15 although it can affect anyone from babies to adults. The condition may not need treatment if it is mild, however more severe cases can cause breathing difficulties and heart problems.

Kyphosis is an excessive outward curvature of the spine leading to hunching of the back. It is commonly due to compression fractures caused by osteoporosis.

Lordosis, also called swayback, causes a concave lower back, thrusting the hips forward and giving a backward-leaning appearance.

Symptoms of spinal deformities include:

  • A visible curvature to the spine
  • Leaning to one side
  • Uneven shoulders
  • One hip higher than the other or a shoulder sticking out
  • Clothes not fitting properly
  • Back pain, more commonly in adult scoliosis
  • As the condition worsens it may cause the spine to twist causing the ribs on one side of the body to stick out more than the other
Causes

Around eight out of 10 cases of scoliosis have no known cause. This is referred to as adolescant idiopathic scoliosis (the most common type).

Congenital scoliosis is present from birth and is due to the bones of the spine failing to form properly in the womb.

Neuromuscular scoliosis is the result of an underlying nerve or muscular condition such as muscular dystrophy or cerebral palsy.

Some people may have a genetic predisposition to the condition as it sometimes runs in families.

Less commonly it may be the result of degeneration of the spine due to ageing or injuries or infections of the spine.

Diagnosis

Your doctor will carry out a physical examination and may check for abnormal reflexes, muscle weakness or numbness. If scoliosis is suspected you will be referred for an X-ray.

This will check whether the spine is curved and, if so, how severe the curvature is. An MRI scan may be recommended to rule out any underlying condition that might cause the scoliosis, or to ensure that there is no contra indications to carrying out any operative intervention.

Children's Treatment

Many people with spinal deformities won’t require surgery.

In the case of babies and small children the curve may improve as they grow so the normal course of treatment is likely to include:

  • Monitoring of the condition with regular examinations and X-rays. This is important not only to check whether the scoliosis is worsening but also because there is a small risk that organs can become cramped which may restrict their growth.
  • Wearing a cast around the back may help to straighten the spine of babies and toddlers. The cast is worn continuously and cannot be removed, although it is changed every few months as they grow.
  • Back braces can prevent the curvature from becoming worse although they cannot correct an existing curve. They are custom-made from rigid plastic and need to be worn 23 hours a day. They are normally only removed for baths, showers, swimming and certain sports. A back brace can be worn as long as the child is growing.
  • Regular exercise to improve muscle strength and flexibility, and reduce back pain.
  • Surgical procedures are normally only recommended in children if the scoliosis is worsening despite other treatments or if they have stopped growing and the scoliosis is severe. Among the surgical procedures that may be offered are:
    • Surgery to insert special rods along the spine to stop the curve worsening as the spine grows. This is normally only offered to children under 10. Every few months the child will need to see a specialist to have the rods lengthened. This is done using a remote control that activates magnets inside the rods and does not require any incisions. When the child has finished growing the rods can be removed and a final surgical procedure carried out to straighten the spine.
    • Spinal fusion involves straightening the spine using metal rods, screws, hooks and sections of bone taken from elsewhere in your body, normally your hip. These remain in the body permanently. The procedure is only offered to people who have stopped growing. Sometimes a back brace is necessary after surgery to protect the back while it heals.
Adult's Treatment

Many people with spinal deformities won’t require surgery.

In adults, scoliosis often causes back pain so a treatment plan might include:

  • Medication for pain relief, normally anti-inflammatories.
  • Regular exercise to strengthen and stretch the back. A physiotherapist may recommend specific exercises to relieve pain although they will not help to improve the curvature of the spine.
  • Spinal injections of steroids and local anaesthetic which can help to relieve pain in the short-term but will not address the underlying cause.
  • Back braces are normally only used as a temporary support to ease pain or in adults who are not well enough to undergo surgery.
  • Surgical procedures may be recommended if the curve in your spine is worsening or if there is severe pain that other treatments have not helped. Among the surgery that may be offered are:
    • Laminectomy: This removes a section of bone in your vertebra to relieve pressure on the nearby nerve.
    • Discectomy: A section of disc between the vertebrae is removed to relieve pressure on the nearby nerve.
    • Spinal fusion: Two or more vertebrae are joined together to straighten and stabilise the spine.

A combination of these different procedures may provide the best results.

Prevention

Scoliosis cannot be prevented and isn’t believed to be linked to bad posture, exercise or diet.

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