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conditions

Scoliosis

Scoliosis is an abnormal sideways curvature of the spine that can occur in children and adults but is most often diagnosed in adolescents. Cases range from mild to severe, with severe scoliosis potentially causing a reduction in lung function and difficulty with movement. What causes scoliosis in children and adolescents is not known. However, scoliosis in adults is most often caused by degenerative spine disorders or osteoporosis. It is also diagnosed in people who have cerebral palsy or muscular dystrophy.

Symptoms of Scoliosis

There is a wide range of symptoms people affected by scoliosis may experience, depending on how severe their case is. The manifestation of scoliosis symptoms can be affected by what part of the spine has a sideways curvature, as well as individual anatomy and health.

Changes in the body can also play a role. Many people are diagnosed with scoliosis at an age when their bones are still growing and may experience more symptoms at varying levels of severity over time. Symptoms may include:

  • Uneven shoulders or waist
    The sideways shift of the spine can cause parts of the body that are typically even to shift.
  • One hip sitting higher than the other
    Similarly, the shift of the spine can affect the anatomy of the pelvis.
  • Prominence of one shoulder blade or one side of the rib cage
    Many people with scoliosis may experience an abnormal spinal rotation along with sideways curvature, causing muscles and bony structures on one side of the body to be prominent.
  • Pain
    Scoliosis-related pain may be caused by compression of nerves in the spine or muscle fatigue. Muscular fatigue can occur when muscles on the side opposite the abnormal curvature work extra hard to maintain good posture.
  • Numbness and weakness in the legs
    If a nerve is pinched in the spine(spinal stenosis), walking for an extended period can cause pain, loss of feeling, and fatigue in the legs.
  • Visible deformity in the back
    Some scoliosis patients may have a noticeable bulge where the spinal abnormality has pushed around the muscles or rib cage.
  • Shortness of breath
    Patients with severe scoliosis may experience trouble breathing easily due to compression of the lungs.

Differences in Scoliosis Symptoms Between Adults and Children

Scoliosis in children is rarely severe, although it can be, and rarely painful, while adults with scoliosis commonly experience pain, numbness, and weakness. This is because adults with scoliosis may have had abnormal curvature their entire life that has progressed to the point of pain.

Other adults with scoliosis may be affected due to disorders that cause degeneration of the spinal structures, making them more prone to compression of the spinal nerves.

Children may experience severe curves and have some of the symptoms that accompany more severe curves, like shortness of breath and even pain. However, it isn’t as common for children with scoliosis to have a problematic disease progression.

Diagnosis

Your child will most likely be diagnosed with scoliosis during their annual physical exam. Unless a child has severe scoliosis, it’s unlikely to be diagnosed by anyone but a doctor. It’s challenging to spot mild cases of scoliosis in anyone, especially a growing child or adolescent who may be self-conscious about their appearance.

Adults are usually diagnosed when they seek treatment for spinal pain. Both groups can be diagnosed with an X-ray, physical examination, and medical history. An X-ray will clearly show the severity of the spinal curvature. It may be followed up with an MRI if Dr. Avramis thinks an underlying condition is causing your scoliosis. Due to the need for frequent scans, Dr. Avramis may offer the option for low-dose, 3D imaging to prevent overexposure to radiation

Treatment

Scoliosis treatment is dependent on the severity of the curve. Mild curves may only require regular checkups to monitor the curve’s progression. Factors Dr. Avramis considers when deciding how to treat your scoliosis include maturity, sex, and curve size.

The goal of treatment is to alleviate scoliosis-associated symptoms and prevent the scoliosis from progressing. If scoliosis surgery is necessary, Dr. Avramis uses minimally invasive techniques to reduce recovery time and post-operative symptoms.

Non-Surgical solutions
  • Brace
    This intervention is ideal for children who are not done growing and have moderate scoliosis. A brace doesn’t fix abnormal spinal curvature but can prevent scoliosis from progressing if worn 13 to 16 hours a day until the child has stopped growing.
  • Pain Medication
    Non-steroidal anti-inflammatory drugs like ibuprofen can help with scoliosis pain relief.
  • Physical Therapy
    Regular physical therapy can help increase core strength.
  • Activity Modification
    Reducing activities that cause symptoms to flare up can be helpful in scoliosis management.
  • Steroid Injections
    Mostly used as a treatment for scoliosis in adults, steroid injections can help manage pain caused by nerve compression in the spine.
Surgical solutions
  • Spinal Fusion
    Two bones in the spine, called vertebrae, are fused together so they can’t move separately. Bonelike material or bone grafts are placed between the two vertebrae while the two bones fuse. This is the most common scoliosis surgery in adults.
  • Rod Placement
    In cases where a severe case of scoliosis progresses quickly from a young age, rods that can expand as a child grows are placed along the spine and can be lengthened every three to six months.
  • Vertebral Tethering
    This procedure involves two screws being placed on the outside of the spine. A cord is threaded through them. When the cord is tightened, the spine straightens. As a child grows, the spine may continue to straighten as the cord gets tighter.
Treatment will also consider any underlying conditions, including osteoporosis, degenerative diseases of the spine, and neuromuscular disorders like muscular dystrophy. Scoliosis treatment is an individual journey for each patient and requires the expert, personalized care that a scoliosis specialist like Dr. Avramis can give you. Working together, you can find relief, implement effective prevention strategies, and enjoy a better quality of life.
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