Scoliosis is an abnormal curvature of the spine that can affect children, teenagers, and adults. On an X-ray, the spine of an individual with scoliosis looks more like the letters “S” or “C” rather than a straight line. There is no consensus among scientists as to the cause of scoliosis, but there is definite agreement that it is more often diagnosed in females and that there seems to be a genetic component, meaning that you may be more likely to have scoliosis if others in your family are also affected.
Most cases of scoliosis are classified as “idiopathic scoliosis”–which simply means that the cause is unknown. Idiopathic scoliosis occurs primarily in adolescents. Adult scoliosis may represent the progression of a condition that began in childhood and was not treated or even diagnosed while the individual was still developing. The condition may have progressed without proper treatment during adolescence. In addition, adult scoliosis can be caused by degenerative changes in the spine, that is disk degeneration and arthritis that occurs with aging.
Childhood or Adolescent Scoliosis
Another type of scoliosis, referred to as neuromuscular scoliosis, affects children with cerebral palsy, spina bifida, and muscular dystrophy. Curvature of the spine in neuromuscular scoliosis is the result of abnormal muscular forces placed on the spine as a result of the underlying condition.
It is important to heed the warning signs of potential scoliosis development. If left untreated, scoliosis can progress and lead to deformity and back pain. When scoliosis is very severe, it can even have a negative effect on the heart and lungs.
Scoliosis, especially in children, can go largely unnoticed since it is rarely painful. Parents should be observant of the following warning signs of scoliosis. These signs usually start to appear at around the age of 10 years old:
- A distinct leaning to one side.
- A prominence or “hump” in the upper or lower back when the child leans over.
- Shoulders that do not appear level when the child is standing straight up.
- Protruding, asymmetric shoulder blades.
- Noticeably uneven waist line.
- An elevated hip on one side.
Importantly, scoliosis is not a disease, but rather a descriptive term. Most cases do not get worse and children should simply undergo periodic checkups to monitor their condition.
Because a large majority of cases will never develop to the point where surgery is required, nonoperative treatment options, such as bracing or periodic observation, will generally be recommended as the primary method of controlling curve progression.
However, if the scoliotic curve is severe when first observed, or if prescribed orthopaedic bracing fails to control the further development of the curve, then surgery may be necessary. In these cases, surgery has been determined to be safe and highly effective treatment for scoliosis.
The operation for scoliosis is a spinal fusion. This is essentially a “welding” process. The basic idea is to realign and fuse together the curved vertebrae so that they heal into a single, solid bone.
With the tools and technology available today, scoliosis surgeons are able to improve curves significantly.
In a spinal fusion, the curved vertebrae are fused together so that they heal into a single, solid bone. This will stop growth completely in the abnormal segment of the spine and prevent the curve from getting worse.
All spinal fusions use some type of bone material, called a bone graft, to help promote the fusion. Generally, small pieces of bone are placed into the spaces between the vertebrae to be fused. The bone grows together – similar to when a broken bone heals.
Metal rods are typically used to hold the spine in place until fusion happens. The rods are attached to the spine by screws, hooks, and/or wires.
Exactly how much of the spine is fused depends upon your curve(s).