Scoliosis

Symptoms of Scoliosis

Most cases of scoliosis are mild, but some spinal deformities worsen as children continue to grow. Severe scoliosis can be disabling. Patients with scoliosis may notice that their shoulders or hips are uneven, skin folds are asymmetric, their head is not centered over their pelvis, or that clothes fit awkwardly or hang unevenly. Typically, scoliosis by itself is not painful, and patients with more than mild back pain often have another diagnosis for pain.

Signs and symptoms of scoliosis may include:

• Uneven shoulders or hips
• Uneven waist
• Abnormal gait, changes with walking
• Leaning to one side
• Muscle spasms
• Reduced range of motion of the spine
• Rotated or twisted spine
• Trouble breathing
• One shoulder blade that appears more prominent than the other
• Sideways curvature in the spine while in a bathing suit

Diagnosis of Scoliosis

The diagnosis is confirmed through physical examination and and an X-ray. Measuring a curve of more than 10 degrees on a posterior-anterior X-ray confirms the diagnosis. If the curve is minor (less than 20 degrees) or the patient is done growing, typically treatment involves only observation. The orthopedic spine surgeon will usually follow the patients with radiographs periodically to ensure the curve does not worsen.

If the surgeon suspects that an underlying condition, such as a spinal tumor, is causing the scoliosis, they may recommend additional imaging such as a CT scan or MRI may be ordered by the doctor to confirm the diagnosis, especially if surgery is being planned.

Your spine surgeon may also perform a neurological exam to check for:

• Muscle weakness
• Numbness
• Abnormal reflexes

Treatment Options for Scoliosis

Most children with scoliosis have mild cases and may not need treatment, just periodic monitoring to ensure the curvature has not worsened. If the child is still growing and has moderate scoliosis, the doctor may recommend bracing. Wearing a brace won’t cure scoliosis, but it can usually help prevent further curvature.

Bracing is usually required after the patient’s spine curvature measures 20-25 degrees, if there is still growth remaining. Scoliosis curves that exceed 45-50 degrees are considered severe and considered for surgical treatment.

In severe cases, your spine surgeon may suggest scoliosis surgery to reduce the spinal curvature and to prevent it from getting worse.

Surgical Treatment of Scoliosis

The most common scoliosis surgery is spinal fusion. Surgical correction of scoliosis involves cutting the bones to allow them to realign more closely with “normal” spinal curvatures in all 3 planes (coronal, sagittal, and axial) and to fuse them in that position, usually stabilizing them with screws and rods. If the scoliosis is due to disc degeneration in an adult, nerves may become pinched, and are decompressed at the time of surgery. Surgery for scoliosis is performed as an inpatient procedure in the hospital and recovery time varies depending on the complexity of the surgery.

If scoliosis is progressing rapidly in a patient at a young age, surgeons can install a rod that can adjust in length as the child grows.