SCOLIOSIS

1. Paediatric Scoliosis

Scoliosis is a condition of side-to-side spinal curves that measure greater than 10º. On an x-ray, the spine of a person with scoliosis looks more like an "S" or a "C" than a straight line. These curves may cause your shoulders or hips to be uneven, depending on where your curves are in your spine.

In more than 80 percent of cases, the cause of scoliosis is unknown — a condition called idiopathic scoliosis. In other cases, scoliosis may develop as a result of degeneration of the spinal discs, as seen with arthritis, osteoporosis or as a hereditary condition that tends to run in families.

Suspected Scoliosis

If scoliosis is suspected following this simple examination, the doctor will usually order X-rays of the entire spine from the neck to the pelvis (back and side views).

Present Scoliosis

If scoliosis is present, the doctor will measure the spine’s curves and provide you with a number, in degrees, to help describe the scoliosis.

How is scoliosis treated in children?

The goal of treatment is to stop the progression of the curve and prevent deformity. Observation and repeated examinations — also referred to as the “watch and wait” approach — may be necessary to determine if the spine is continuing to curve. These are used when a person has a curve that is less than 20 degrees and who is still growing.

For actively growing children with scoliosis curves between 20 and 50 degrees, bracing is recommended. An external torso brace, or TLSO, is worn for a prescribed number of hours. The brace applies corrective pressure to the growing spine, preventing further worsening of the scoliosis.

Surgery is a recommended treatment option for a child with severe scoliosis or a curve that has worsened to more than 50 degrees

2. Adult Idiopathic Scoliosis

Scoliosis that develops with no known cause is the most common type. When idiopathic scoliosis begins in adolescence and continues into adulthood with increasing symptoms, it’s called adult idiopathic scoliosis.

Idiopathic scoliosis affects the upper (thoracic) or lower (lumbar) spine. Discs and joints can degenerate, which may result in spinal stenosis. Scoliosis can also cause arthritis in the spinal joints, resulting in bone spurs.

Scoliosis Symptoms

In adults, scoliosis symptoms can cause a gradual loss of function. They include:

  • Low back pain and stiffness

  • Numbness, cramping, and shooting pain in the legs from pinched nerves

  • Fatigue from the strain on the lower back and leg muscles

  • One shoulder or hip may be higher than the other

  • One arm may hang lower than the other

  • A rib hump occurs in the lower back

3. Degenerative Scoliosis

Degenerative scoliosis usually begins after age 40, when the age and a deteriorating spine degeneration both my cause scoliosis to develops. Other factors include facet joint arthritis and collapse of the disc spaces. Degenerative scoliosis is often related to osteoporosis, especially in women and the spine slowly sags into a curve.

Degenerative Scoliosis Symptoms

Degenerative scoliosis usually affects the lumbar, or lower, spine. Symptoms include back pain, numbness and shooting pain down the legs.

Diagnosis for Scoliosis

Your condition can be evaluated using an X-ray of your entire spine. If you have leg pain or nerve problems, you may also have an MRI (magnetic resonance imaging).

Nonsurgical treatments are effective for most adults with either idiopathic or degenerative scoliosis. These include periodic observation and:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen can reduce swelling and relieve pain.

  • Exercises to strengthen the core abdomen and back muscles.

  • Epidurals or nerve block injections can provide temporary relief of leg pain and other symptoms.

  • Temporary braces offer short-term pain relief.

When Scoliosis Surgery Can Help

If nonsurgical treatments provide no relief and you have a spinal imbalance with disabling back or leg pain, scoliosis surgery may be an option:

  • Laminectomy, also called decompression surgery, removes some or all the lamina part of the vertebra to relieve pressure on the spinal cord

  • Microdiscectomy (microdecompression), a minimally invasive surgery to relieve pressure on the nerves

  • Spinal fusion permanently joins two vertebras with bone or synthetic graft material

  • Osteotomy realigns spinal segments

  • Vertebral column resection realigns the spine when an osteotomy or other surgeries don’t correct the scoliosis

Recovery depends on your condition and type of surgery, though it can take up to a year to fully recover. You should not lift heavy objects and minimise bending for the first 6—12 weeks.

Book your Appointment

Mr Ali Humadi consults at locations across Melbourne, including Coburg, Bundoora, Sandringham and Wantirna. Patients requiring urgent referral are welcome.