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Answered: Your Most Burning Questions About Scoliosis

July 30, 2017

What is Scoliosis?

Scoliosis is an abnormal curvature of the spine that usually occurs around the time of the growth spurt before puberty.  While there are some diseases like muscular dystrophy and cerebral palsy that can cause scoliosis, in most cases, the cause is "idiopathic" or unknown.  The curvature may stabilize or may progress in severity.  Most cases are mild but some can be severe and require extensive surgery correction.  Untreated, the severe cases can result in decreased function and possibly even compromise of the cardiac or respiratory system.  Patients and parents of patients diagnosed with scoliosis have many questions regarding this condition. The following questions, summary answers, and links are meant to be a starting point to answering some of these questions.  While this article is not a substitute for an evaluation by a physician or other health care provider, the information may be helpful in discussing the issues associated with your physician or surgeon.

What is the cause of scoliosis?

Doctors don't know what causes the most common type of scoliosis although it appears to involve hereditary factors, because the disorder tends to run in families. Less common types of scoliosis may be caused by: Neuromuscular conditions, such as cerebral palsy or muscular dystrophy.5

Scoliosis Symptoms and causes - Mayo Clinic

Can scoliosis be cured?

The doctor will determine how likely it is that the curve will get worse, and then suggest treatment options to meet the child's specific needs. Most scoliosis surgeons agree that children who have very severe curves (50 degrees and higher) will need surgery to lessen the curve and prevent it from getting worse.6

Treatment & Coping | Scoliosis Research Society

What are the different types of abnormal spinal curvature?

There are three main types of spine curvature disorders, including:

•Lordosis. Also called swayback, the spine of a person with lordosis curves significantly inward at the lower back.

•Kyphosis. Kyphosis is characterized by an abnormally rounded upper back (more than 50 degrees of curvature).

•Scoliosis. A person with scoliosis has a sideways curve to their spine. The curve is often S-shaped or C-shaped.7

WebMd: Spine Curvature Disorders: Lordosis, Kyphosis, Scoliosis, and More

Can you correct scoliosis without surgery?

Scoliosis Surgery: Surgery to correct adult scoliosis is an option when nonsurgical treatments do not relieve pain or symptoms. ... Surgical reconstruction involves some correction of the curvature with the goal to relieve pain and prevent the curvature from worsening in the future.8

Spine MD: Surgical / Non-surgical Adult Scoliosis Treatments - VA, DC, MD

Can scoliosis be cured by a chiropractor?

Like all other treatments for scoliosis, aside from the corrective brace prescribed to adolescents with scoliosis, chiropractic does not correct, cure or reverse scoliosis. Chiropractors may be able to address other symptoms or issues the patient may be experiencing.9

Chiroone.Net: Living With Adult Scoliosis: Know Your Options

Can scoliosis cause pain?

Most of the time scoliosis does not cause pain in children or teens. When back pain is present with scoliosis, it may be because the curve in the spine is causing stress and pressure on the spinal discs, nerves, muscles, ligaments, or facet joints. It is not usually caused by the curve itself.10

Scoliosis-Symptoms - WebMD

What do you do for scoliosis?

Brace treatment is generally used to prevent scoliosis from getting worse when you have:

•A curve that is moderate in size (20 to 40 degrees) AND.

•A curve that is progressive (has increased by more than 5 degrees) OR.

•A curve that is over 30 degrees when first diagnosed AND.

•A lot of growing yet to do.11

Nonsurgical Treatment Options for Scoliosis-OrthoInfo - AAOS

Can scoliosis cause pain?

Most of the time scoliosis does not cause pain in children or teens. When back painis present with scoliosis, it may be because the curve in the spine is causing stress and pressure on the spinal discs, nerves, muscles, ligaments, or facet joints. It is not usually caused by the curve itself.12

Scoliosis-Symptoms - WebMD

Can scoliosis get worse in adulthood?

Most cases of scoliosis are mild, involving small curves in the spine that do not get worse. Small curves usually do not cause pain or other problems. Usually a doctor examines the child every 4 to 6 months to watch for any changes. In moderate or severe cases of scoliosis, the curves continue to get worse.13

Emedicinehealth.Com: Scoliosis - What Happens When You Have Scoliosis: Healthwise ...

What can happen if scoliosis goes untreated?

For most patients with what we call idiopathic scoliosis, the curvature is on the right side of the thoracic spine, or the upper back. If the curve is severe, you can see a rib hump. If left untreated, severe cases of scoliosis can worsen over time, impairing heart and lung function.14

Scoliosis can pose threat later in life if untreated - NY Daily News

What degree of scoliosis requires treatment?

Most scoliosis surgeons agree that children who have very severe curves (45-50° and higher) will need surgery to lessen the curve and prevent it from getting worse. The operation for scoliosis is a spinal fusion.15

Surgical Treatment for Scoliosis-OrthoInfo - AAOS

What percentage of scoliosis patients have surgery?

These disorders require additional and different treatment from adolescent idiopathic scoliosis. Three to five percent of people have curves greater than 10° but only 0.2-0.3% require treatment. There is a difference between females and males with AIS.16

Scoliosis - Know Your Back.org

Is scoliosis a genetic disease?

Adolescent idiopathic scoliosis probably results from a combination of genetic and environmental factors. Studies suggest that the abnormal spinal curvature may be related to hormonal problems, abnormal bone or muscle growth, nervous system abnormalities, or other factors that have not been identified.17

adolescent idiopathic scoliosis - Genetics Home Reference

What is spinal fusion for scoliosis?

In spinal fusion for scoliosis, rods, hooks, wires, or screws are attached to the curved part of the backbone and the spine is straightened. Small pieces of bone are then put over the spine. The bone pieces will grow together with the spinal bone, fusing it into the proper position.18

What is the surgery for scoliosis?

The main type of surgery for scoliosis involves attaching rods to the spine and doing a spinal fusion. Spinal fusion is used to stabilize and reduce the size of the curve and stop the curve from getting worse by permanently joining the vertebrae into a solid mass of bone.19

Scoliosis-Surgery - WebMD

Spinal Fusion for Scoliosis - WebMD

How long does spinal surgery for scoliosis take?

Spinal fusion can take as little as 2 ½ hours, and as long as 6 or 7 hours, occasionally even longer. How long it takes depends on the number of vertebrae being fused, how badly the vertebrae are diseased, whether spinal nerves are pinched and need to be decompressed, and whether there is scarring from prior surgeries.20

Lumbar Spinal Fusion (posterior) - Intermountain Healthcare

How long does it take for a fusion to heal?

Lumbar spinal fusion is surgery to join, or fuse, two or more vertebrae in the low back. ... There are different methods of spinal fusion. Bone is taken from the pelvic bone or from a bone bank. The bone is used to make a bridge between vertebrae that are next to each other.21

Spinal Fusion Surgery Types, Why It's Done, and What To Expect

What are the risks from surgery for scoliosis?

Other risks of scoliosis surgery are summarised below.

•Death and neurological damage

•Loss of normal spinal function

•Strain on un-fused vertebrae

•Post-surgery pain

•Infection and inflammatory processes

•Curvature progression

•Decompensation and increased sagittal deformity

•Increased torso deformity.22

 

Rate of complications in scoliosis surgery – a systematic review of the Pub Med literature

What can I expect after a spinal fusion?

  • Spinal Fusion Surgery Recovery: At The Hospital (One to Two Days)
  • Spinal Fusion Surgery Recovery: After Discharge (Three to Six Days)
  • One to Four Weeks After Spine Fusion Surgery. Spinal Fusion
  • Surgery Recovery: One to Three Months Post-Operation.

 

There are several factors that can extend one's hospital stay and/or negatively impact the recovery process and clinical success of the surgery. These factors include, but are not limited to:

  • Obesity
  • Osteoporosis
  • Smoking (nicotine)
  • Chronic steroid use
  • Diabetes Mellitus and certain other chronic illnesses
  • Prior back surgery or attempted fusion
  • Malnutrition
  • Post-surgery activities
  • Depression
  • Long-standing use of narcotics before surgery23

Postoperative Care for Spinal Fusion Surgery - Spine-Health

Resources:

  1. What Is Scoliosis and What Causes It?
  2. Scoliosis: What You Need to Know
  3. Scoliosis
  4. Scoliosis Center
  5. Scoliosis Symptoms and causes - Mayo Clinic
  6. Treatment & Coping | Scoliosis Research Society
  7. WebMd: Spine Curvature Disorders: Lordosis, Kyphosis, Scoliosis, and More
  8. Spine MD: Surgical / Non-surgical Adult Scoliosis Treatments - VA, DC, MD
  9. Chiroone.Net: Living With Adult Scoliosis: Know Your Options
  10. Scoliosis-Symptoms - WebMD
  11. Nonsurgical Treatment Options for Scoliosis-OrthoInfo - AAOS
  12. Scoliosis-Symptoms - WebMD
  13. Emedicinehealth.Com: Scoliosis - What Happens When You Have Scoliosis: Healthwise
  14. Scoliosis can pose threat later in life if untreated - NY Daily News
  15. Surgical Treatment for Scoliosis-OrthoInfo - AAOS
  16. Scoliosis - Know Your Back.org
  17. adolescent idiopathic scoliosis - Genetics Home Reference
  18. Scoliosis-Surgery - WebMD
  19. Spinal Fusion for Scoliosis - WebMD
  20. Lumbar Spinal Fusion (posterior) - Intermountain Healthcare
  21. Spinal Fusion Surgery Types, Why It's Done, and What To Expect
  22. Rate of complications in scoliosis surgery – a systematic review of the Pub Med literature
  23. Postoperative Care for Spinal Fusion Surgery - Spine-Health

 

 

 

About the Author
Dr. John B. Adams is board certified in Pain Management by the American Board of Medical Specialties and the American Board of Interventional Pain Physicians. With almost 2 decades of experience, he offers patients access to state-of-the-art pain management, emphasizing a multidisciplinary approach to pain management utilizing precision injections, neuromodulation technology, physical therapy, behavioral medicine and judicious use of medications including help with patients titrating off opiates (narcotic pain medications).

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