Scoliosis
Scoliosis in nagpur is medically described as an abnormal curvature of the spine, to one side more than the other. Of all ages can be affected by scoliosis; however, it most commonly occurs in children and adults.
Symptoms:
- Prominent ribs or spine
- Breathing difficulty
- Back pain
- Shoulder blades
Types of Scoliosis:
1. Adolescent idiopathic scoliosis (AIS): This constitutes the majority, which is approximately 80%.
2. Adult scoliosis: These ones develop within people who are of the age of 18 years and above.
3. Congenital scoliosis: This is a condition since birth.
4. Degenerative Scoliosis: Caused by the wear and tear process on the back over the years.
What Is a Scoliosis?
Scoliosis is a condition associated with the spine. It is basically characterized by:
1. Curvature of the spine: The spine curves to the left or right side in an “S” or “C” shape.
2. Lateral curvature of the spine: The vertical orientation of the spine is a deviated, causing unevenness in the torso.
3. Rotational deformity: The spine rotates with the prominence of ribs or shoulder blades.
Scoliosis can be classified into a types, among which include:
– Idiopathic: That has no known cause.
– Congenital (present at birth)
– Degenerative
– Neuromuscular conditions
All ages can be affected by scoliosis but commonly begins at some of these ages:
– Adolescents; 10-18 years
– Young adults; 18-25 years
– Adults; over 25 years
The symptoms of scoliosis may include:
– Asymmetric or uneven shoulder or shoulder blades
– Waistline
– Prominent ribs and spine; difficulties in breathing
Adults may suffer from a backache
In these conditions, early detection and treatment can lead to much better results.
Types of Scoliosis:
- Idiopathic Scoliosis:
– Most common type (accounts for 80-85% of cases).
– Cause: Unknown, though genetic factors may play a role.
Subtypes:
– Infantile idiopathic scoliosis: Occurs in children under 3.
– Juvenile idiopathic scoliosis: Occurs between ages 3-10.
– Adolescent idiopathic scoliosis: Develops after age 10 and often during growth spurts. - Congenital Scoliosis:
– Cause: Abnormal spinal development in the womb, such as missing or fused vertebrae.
– Diagnosis: Often noticed early in childhood. - Neuromuscular Scoliosis:
– Cause: Secondary to conditions that affect muscles or nerves, such as cerebral palsy, muscular dystrophy, and spina bifida.
– Progression: Often more severe and can progress rapidly. - Degenerative Scoliosis (Adult Scoliosis):
– Cause: Degenerative changes in the spine due to aging, such as arthritis, disc degeneration, or osteoporosis.
– Age of Onset: Common in adults over 50. - Functional (Non-structural) Scoliosis:
– Cause: A temporary curvature due to conditions like muscle spasms, leg length discrepancy, or inflammation.
– Reversibility: The curve corrects when the underlying cause is treated.
Symptoms of Scoliosis:
Symptoms depend on the severity of the curve and the location in the spine. Common symptoms include:
- Uneven shoulders: One shoulder appears higher than a other.
- Uneven waist or hips: One hip may be raised higher or more prominent.
- Visible curvature: The spine appears curved when viewed from behind.
- Back pain: Pain is more common in adults, especially with degenerative scoliosis.
- Fatigue: Caused by the strain of supporting the abnormal curvature.
- Difficulty breathing: In severe cases, the curvature can compress the lungs, making breathing difficult.
- Asymmetrical rib cage: In some cases, the ribs may stick out more on one side.
Diagnosis of Scoliosis:
- Physical Examination: The doctor will check for visible signs of scoliosis by examining posture and spine alignment. The Adams Forward Bend Test is the commonly used.
- Imaging Tests:
- X-rays: The most important diagnostic tool to measure the degree of spinal curvature (Cobb angle).
- MRI or CT Scan: Used to assess any underlying spinal cord issues or other abnormalities.
Treatment Options:
Treatment for scoliosis depends on the severity of the curve, the patient’s age, or the type of scoliosis.
- Observation:
– For mild curves (under 20 degrees), especially in children who are still growing, doctors may recommend regular monitoring every 4-6 months to check for progression. - Bracing:
– Used for moderate curves (25-40 degrees) in children and adolescents who are still growing.
– Goal: To prevent the curve from worsening as the child grows, but it cannot correct an existing curve.
Types of Braces:
– Thoracolumbosacral Orthosis (TLSO): A common type that covers the torso.
– Milwaukee brace: A full-torso brace used for curves higher in a spine. - Physical Therapy:
– Strengthening exercises to support the muscles around the spine and improve posture.
– Techniques like the Schroth method, which focuses on improving posture and spinal alignment, are sometimes used. - Surgical Treatment:
– Spinal Fusion: The most common surgery for scoliosis, used for severe curves (typically over 45-50 degrees) or when bracing fails to prevent progression.
– In spinal fusion, the vertebrae in the curved section of the spine are fused together using bone grafts and metal rods, screws, or hooks to hold the spine straight while the bone heals and solidifies.
– Vertebral Body Tethering (VBT): A newer, less invasive surgical option where a flexible cord is attached to the spine. It allows for some spinal flexibility or may correct the curve as the child grows. - Other Treatment Options:
– Pain Management: For adults with scoliosis-related back pain, treatment options like nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, or injections (such as corticosteroids) can help manage pain.
– Chiropractic Care: While it cannot correct scoliosis, some patients find relief through spinal manipulation.
Prognosis:
- Children and Adolescents: If scoliosis is detected early and treated with bracing or surgery, the long-term prognosis is usually good. Many individuals can lead normal lives without significant limitations.
- Adults: In adults with degenerative scoliosis, treatment focuses more on pain management and improving function, though surgery may be required in severe cases.
Complications:
- Severe Curves: If left untreated, severe scoliosis can lead to complications such as:
- Chronic back pain.
- Breathing difficulties: In cases where the curvature affects the rib cage and lungs.
- Spinal deformities: Permanent changes in posture and alignment.
What procedures Scoliosis?
Scoliosis treatment procedures include:
1. Observation: Regular check-ups to monitor the curve’s progression.
2. Bracing: Wearing a brace to support the spine and prevent further curvature.
3. Physical therapy: Exercises to improve posture, strength, and flexibility.
4. Pain management: Medication or injections to alleviate back pain.
5. Surgery:
– Spinal fusion: Joining two or more vertebrae to stabilize the spine.
– Instrumentation: Using rods, screws, or other instruments to support the spine.
– Vertebral body replacement: Replacing damaged vertebrae with artificial ones.
– Minimally invasive surgery: Using smaller incisions and specialized instruments.
6. Scoliosis correction procedures:
– Anterior scoliosis correction: Approaching the spine from the front.
– Posterior scoliosis correction: Approaching the spine from the back.
– Lateral scoliosis correction: Approaching the spine from the side.
7. Other procedures:
– Vertebroplasty/Kyphoplasty: Strengthening vertebral bodies with bone cement.
– Spinal osteotomy: Cutting and realigning vertebrae to improve alignment.
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