back pain, scoliosis

SCOLIOSIS

Scoliosis is sideways curving and turning of the bones of a spine. Scoliosis is a medical term taken from a Greek word meaning curvature. This disorder may develop during childhood, before birth or may also develop during adulthood and it causes the spine to curve to the left or right. https://www.nhs.uk/conditions/scoliosis/treatment-in-children/

SCOLIOSIS IN CHILDREN

There are six types of scoliosis that may affect children:

  • congenital scoliosis. This occurs when the spine does not develop properly in the womb,
  • neuromuscular scoliosis. This caused by brain, spinal cord and muscular system disorders,
  • infantile idiopathic scoliosis. This is diagnosed in children ages 0 to 3,
  • juvenile idiopathic scoliosis. This is diagnosed in children ages 4 to 10,
  •  adolescent idiopathic scoliosis. This is diagnosed in young people ages 11 to 18,
  • syndromic scoliosis. This develops as part of an underlying syndrome or disorder (e.g Marfan syndrome, muscular dystrophy).

Many types of scoliosis are idiopathic – that means there is no known cause.

TREATMENTS FOR CHILDREN WITH SCOLIOSIS

The cause of scoliosis and severity are important facts that help determine the treatment plan for scoliosis in children. Three primary options for treatment of scoliosis in children: (a) observation (b) spinal bracing and (c) spine surgery.

At times, observation is the only treatment warranted. If more treatment is necessary, spinal bracing is the standard way to help manage or prevent curve progression and improve deformity. For advance cases of scoliosis, a doctor may recommend a type of spine surgery called spinal fusion to treat deformity.

SCOLIOSIS IN ADULTS

Scoliosis in adults is either degenerative or it is de novo (de novo is the term meaning ‘new’).

Degenerative scoliosis happens to an adult who has had a history of scoliosis. The spine starts to show wear and tear due to age. This wear and tear can cause the spine to collapse causing the curve to increase.

De novo stenosis first appears in adulthood due to wear and tear. Again in this case, this can results in a curve of the spine. In both types of adult scoliosis (degenerative & de novo) are usually diagnosed after an adult reaches the ages of 40 or 50 years. https://www.nhs.uk/conditions/scoliosis/treatment-in-adults/

TREATMENTS FOR ADULTS WITH SCOLIOSIS

There are two main treatment options for adults with scoliosis: (a) surgical and (b) non-surgical.

The most common spinal surgery used to treat scoliosis is spinal fusion. During this procedure the spine is fused to bone grafts or substitutes to hold the spine in a straight position. Fusion is often incorporated into other surgical procedures, including, but not limited to:

  • decompression fusion. In this procedure pressure is relieved by removing nerves or tissue pressing on the spine followed by fusion. This procedure is performed when the deformity is not severe and the priority is to relieve symptoms from spinal stenosis.
  • surgical stabilization. If scoliosis becomes more severe, screws and rods can be attached to the spine which are then linked together by metal rods, followed by fusion.
  • osteotomy. This procedure is performed when the deformity must be corrected beyond what rods and screws can achieve.
  • vertebral column resection. In this procedure the entire sections of vertebrae are removed followed by a realignment of the spine by osteotomy and the fusion. This procedure is reserved for the most severe deformity and can carry a higher complication rate.

Non-surgical treatments are:

  • physical therapy
  • chiropractic care
  • epidural or nerve block injection (for pain related to pinched nerve or arthritis)
  • acupuncture
  • massage therapy
  • posture therapy
  • yoga
  • ergonomic modifications
  • exercises to strengthen the abdominal muscles and back
  •  over-the-counter pain medication.

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