ScoliosisDeformityCorrection

Scoliosis

Scoliosis is a curvature of the spine (deformation) that affects 2% of the population. The disorder can be congenital (present at birth), but often it is not diagnosed until adulthood. Scoliosis is caused by spinal degeneration or a curvature from childhood which worsens over time. Symptoms vary with age of onset and severity of the curvature; cosmetic problems including sitting imbalance, breathing difficulty or delayed development is common findings in infants and young children. The condition can present observable symptoms such as uneven shoulders, an elevated hip, or protruding shoulder blades. These symptoms are usually not painful, and a diagnostic exam is often the only way the condition is diagnosed.

Consulting orthopaedic doctors who are familiar with the unique characteristics of scoliosis would offer the best medical expertise and solution. Here at Udai Omni, unnatural spine curvature (adult and paediatric), its correction is a speciality. We have helped numerous patients resume active lifestyles and mobility. We also have access to the most advanced diagnostic and treatment resources.

Types of Scoliosis

  • Infantile Scoliosis occurs in children less than 3 years of age and is most commonly associated with other serious congenital or neurodegenerative disorders like cerebral palsy, tethered spinal cord, and myelomeningoceles, among others. Surgery is sometimes necessary, but often non-operative techniques are used to allow for spinal growth prior to a spinal fusion procedure.
  • Juvenile Scoliosis occurs in the 3 to 10-year age group. These deformities tend to be progressive as children grow in more than half of cases. Bracing is often used as an initial treatment until the child grows sufficiently and reaches an age and body size suitable to appropriate surgical correction. In the more severe cases, surgery is performed before adolescence.
  • Adolescent Idiopathic Scoliosis is the most common form of scoliosis, occurring in the 10 – 17-year-old patients. There is no identifiable cause for this disorder, and it varies greatly in it symptoms and severity. Decisions for treatment are based on the severity of the curvature, and progression or worsening of the curvature. This condition is typically not painful, except in the most severe cases and not associated with neurologic deficits including lower extremity weakness or numbness. The majority of these conditions occur in the thoracic spine, below the neck and above the low back region. Scoliosis that was thought to be stable during adolescence and young adult life may worsen with the appearance of degenerative arthritis. This neglected or decompensated scoliosis may become severely symptomatic in later adult life.
  • Adult Degenerative Scoliosis is an increasingly more common form of scoliosis which appears in adult life along with the onset of degenerative arthritis in the lumbar spine. These patients did not have scoliosis as children. It worsens with age and is often associated with pain and nerve compression from spinal stenosis.

Scoliosis treatment: what you need to know

  • Scoliosis is often first diagnosed in children, but treatment and monitoring may be lifelong.
  • Early intervention yields the best results when treating scoliosis.
  • Common signs of scoliosis include a difference in shoulder height when viewed from the back, a head that is not centred with the rest of the body, or a difference in hip height or position.
  • Scoliosis usually doesn’t cause pain.
  • Bracing is a common treatment for scoliosis. In severe cases, surgery may be required.

Treatment

Most children with scoliosis have mild curves and probably won’t need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines. While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include:

  • Sex. Girls have a much higher risk of progression than do boys.
  • The severity of curve. Larger curves are more likely to worsen with time.
  • Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do c-shaped curves.
  • Location of curve. Curves located in the centre (thoracic) section of the spine worsens more often than do curves in the upper or lower sections of the spine.
  • Maturity. If a child’s bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effective in children whose bones are still growing.
  • Braces
Braces

If your child’s bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a brace won’t cure scoliosis or reverse the curve, but it usually prevents further progression of the curve.

The most common type of brace is made of plastic and is contoured to conform to the body. This close-fitting brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips.

Most braces are worn day and night. A brace’s effectiveness increases with the number of hours a day it’s worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities.

Braces are discontinued after the bones stop growing. This typically occurs:

  • About two years after girls begin to menstruate
  • When boys need to shave daily
  • When there are no further changes in height
Surgery

Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion.

In spinal fusion, surgeons connect two or more of the bones of the spine (vertebrae) together, so they can’t move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuse together.

If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature and is usually lengthened every six months.

Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed.

Kyphosis

Kyphosis is a forward rounding of the back. Some rounding is normal, but the term “kyphosis” usually refers to an exaggerated rounding of the back. While kyphosis can occur at any age, it’s most common in older women.

Age-related kyphosis often occurs after osteoporosis weakens spinal bones to the point that they crack and compress. Other types of kyphosis are seen in infants or teens due to malformation of the spine or wedging of the spinal bones over time.

Mild kyphosis causes few problems, but severe cases can cause pain and be disfiguring. Treatment for kyphosis depends on your age, the cause of the curvature and its effects.

Symptoms

In addition to an abnormally curved spine, kyphosis can also cause back pain and stiffness in some people. Mild cases of kyphosis may produce no noticeable signs or symptoms. Make an appointment with your doctor if you notice an increased curve in your upper back or in your child’s spine.

Causes

The individual bones (vertebrae) that make up a healthy spine look like cylinders stacked in a column. Kyphosis occurs when the vertebrae in the upper back become more wedge-shaped. This deformity can be caused by a variety of problems, including:

  • Osteoporosis. This bone-thinning disorder can result in crushed vertebrae (compression fractures). Osteoporosis is most common in older adults, particularly women, and in people who have taken high doses of corticosteroids for long periods of time.
  • Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks dry out and shrink, which often worsens kyphosis.
  • Scheuermann’s disease. Also called Scheuermann’s kyphosis, this disease typically begins during the growth spurt that occurs before puberty. Boys are affected more often than are girls. The rounding of the back may worsen as the child finishes growing.
  • Birth defects. If a baby’s spinal column doesn’t develop properly in the womb, the spinal bones may not form properly, causing kyphosis.
  • Syndromes. Kyphosis in children can also be associated with certain syndromes, such as Marfan syndrome or prader-willi disease.
  • Cancer and cancer treatments. Cancer in the spine can weaken vertebrae and make them more prone to compression fractures, as can chemotherapy and radiation cancer treatments.

An increased curve in the upper spine also can be caused by slouching. Called postural kyphosis, this condition doesn’t involve any deformities in the spine. It’s most common in teenagers.

Kyphosis may cause the following complications:

  • Body image problems. Adolescents especially may develop a poor body image from having a rounded back or from wearing a brace to correct the condition.
  • Back pain. In some cases, the misalignment of the spine can lead to pain, which can become severe and disabling.
  • Decreased appetite. In severe cases, the curve may cause the abdomen to be compressed and lead to decreased appetite.

Kyphosis treatment depends on the cause of the condition and the signs and symptoms that are present.

Kyphosis treatment: what you need to know

There are several different types of kyphosis, including Scheuermann’s kyphosis, congenital kyphosis and kyphosis caused by osteoporosis.

Depending on the type and severity of the spinal abnormality, no treatment may be required.

When treatment is required, bracing may be enough. In severe cases, surgery may be an appropriate treatment.

Treatments
Your doctor may suggest:
  • Pain relievers. If over-the-counter medicines — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin ib, others) or naproxen (Aleve) — aren’t enough, stronger pain medications are available by prescription.
  • Osteoporosis drugs. In many older people, kyphosis is the first clue that they have osteoporosis. Bone-strengthening drugs may help prevent additional spinal fractures that would cause your kyphosis to worsen.
Therapy
Some types of kyphosis can be helped by:
  • Exercises. Stretching exercises can improve spinal flexibility and relieve back pain. Exercises that strengthen the abdominal muscles may help improve posture.
  • Bracing. Children who have Scheuermann’s disease may be able to stop the progression of kyphosis by wearing a body brace while their bones are still growing.
  • Healthy lifestyle. Maintaining a healthy body weight and regular physical activity will help prevent back pain and relieve back symptoms from kyphosis.
  • Maintaining good bone density. Proper diet with calcium and vitamin d and screening for low bone density, particularly if there is a family history of osteoporosis or history of the previous fracture, may help older adults avoid weak bones, compression fractures and subsequent kyphosis.
Surgical and other procedures

If the kyphosis curve is very severe or if the curve is pinching the spinal cord or nerve roots, your doctor might suggest surgery to reduce the degree of curvature.

The most common procedure, called spinal fusion, connects two or more of the affected vertebrae permanently. Surgeons insert pieces of bone between the vertebrae and then fasten the vertebrae together with metal rods and screws until the spine heals together in a corrected position.

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