Your spine is a flexible structure made of bone, cartilage, and connecting tissues. To best distribute your body weight, it curves vertically in an S-shape. That also helps to reduce pressure on any single area of your back.
Scoliosis occurs when the natural structure diverges from the ideal. Instead of just a vertical S-curve, the spine also takes on a sideways S- or C-shaped curve. Scoliosis can happen at any age, but it’s usually seen in children and adolescents, especially in girls experiencing growth spurts. It all adds up to some 6-9 million Americans who are affected.
At Polaris Spine & Neurosurgery Center, with two offices in the College Park and Sandy Springs areas of Atlanta, Georgia, our expert team of neurosurgeons, physical medicine doctors, and pain management specialists understands how difficult it can be to live with scoliosis.
While people we see have relatively mild cases of scoliosis, we know that effective treatment can make a huge difference in the quality of life. Here’s what you need to know about the basics of scoliosis, as well as what we can do to provide effective treatment.
Scoliosis is the most common spinal deformity in school-age children, and while there are a number of different types, the two primary types are idiopathic and degenerative.
Idiopathic means the condition has no known cause, and it’s the most common form. Adolescent idiopathic scoliosis (AIS) accounts for 85% of all cases, with girls outnumbering boys by 10:1.
Degenerative scoliosis affects about 38% of the population and occurs when the spinal discs degrade asymmetrically, producing a curve. It generally affects the lumbar (lower back) spine, and its symptoms are usually milder than those of idiopathic scoliosis.
The most common symptoms of degenerative scoliosis include low back pain and difficulty standing up straight. It can cause sciatica, which is an impingement of the L5 nerve, causing pain radiating from the lower back through one side of the buttocks and down the leg.
Additional symptoms of both types include:
When you come in for an evaluation, we examine your back while you stand with your arms at your sides. That lets us see if your shoulders and waist levels are symmetrical, and if your spine curves sideways as well as vertically. Next, we observe your back as you bend forward, measuring the curvature in both the upper and lower back.
We may use imaging tests to help visualize your spine, including X-rays, CT scans, or an MRI scan.
Because the cause of scoliosis is usually different in adults than in children, we treat them differently. For adult scoliosis, we recommend:
We may recommend surgery in severe cases where there is >50% spinal curvature coupled with bowel or bladder symptoms and/or nerve damage in the legs.
The primary treatment options in children are bracing and surgery.
Bracing is a commonly used treatment in children, but according to the American Association of Neurological Surgeons, it’s only an effective option if the child is still growing and their curvature is no more than 25-40 degrees. A brace won’t straighten the spine, but it can prevent the side-to-side curvature from becoming worse.
To be effective, patients need to wear the brace for 16-23 hours each day until they stop growing — the more they wear it, the more effective it will be.
We generally reserve surgical procedures for patients with spinal curvatures greater than 40 degrees that are getting worse or if symptoms interfere with daily life. In children, the two primary goals of surgery are to stop the progression of the curve and to diminish spinal deformity.
The most common surgical procedure is a spinal fusion. The vertebrae are fused together using a combination of a bone grafts, rods, and screws. Rods keep the spine straight, the screws hold the rods in place, and the rods’ positions can be adjusted to keep up with the child’s development. Eventually, the graft and vertebrae fuse into a single, stable bone.
If you or your child has an abnormal spinal curvature, come see one of our spine specialists to get effective treatment. Give Apex Spine and Neurosurgery a call at either of our offices to set up a consultation, or book online today.