It is estimated that approximately 3% of the adolescent population has scoliosis of the spine, but in most cases, the curvature does not exceed 30 degrees. If you would like to know more about this condition, we invite you to read this article prepared by our spine specialists at Instituto Clavel.
Most people who develop scoliosis, or curvature of the spine, do not find it seriously restricts their lives, although it may make it more difficult to perform certain tasks. However, as the spinal curvature worsens (in severe cases, it can be more than 50 degrees), it reduces the space in the rib cage and this can cause difficulty breathing. In addition, when the deformity principally affects the lumbar spine, it can become painful in adulthood when combined with a degenerative spinal pathology.
This is why, if you have been diagnosed with scoliosis, it is very important to see your doctor periodically to have your condition monitored. Once the specialist has diagnosed the type and degree of the scoliosis, they can recommend the appropriate treatment options to control the condition. In case it gets worse and the patient needs surgery, the doctor will be able to make a decision in time to prevent the deformity from progressing.
Scoliosis: classification by grades
If you look at the spine from the front or back it should be straight, but when scoliosis appears you can see a deviation of the spine to the right or left, causing a curvature. When that curve exceeds 10 degrees, it is considered scoliosis. Radiographic imaging will allow the doctor to confirm the grade of the scoliosis as mild, moderate, or severe, based on the following:
- Mild scoliosis: when the curvature is not more than 20 degrees.
- Moderate scoliosis: when the curvature is between 25 degrees - 40 degrees.
- Severe scoliosis: in these cases, the curvature is 50 degrees or more.
Scoliosis is easy to detect in most cases, by observing any of the following: the patient’s torso tilts towards one side, or one shoulder appears higher than the other or a shoulder blade protrudes more than the other, or the hips do not appear level. However, there are cases in which it is not so obvious. For this reason, a doctor should always take a look at a patient’s spine, even during a routine physical examination.
When is scoliosis surgery needed?
Scoliosis in children, or in patients still in a period of growth, should be operated on when it reaches a degree that could cause problems in adulthood. In the case of patients whose skeletal structure has already reached maturity, other factors are taken into account.
Scoliosis in adults may require surgical treatment when it is associated with back pain that cannot be controlled with conservative treatments. In addition, when there is pain accompanied by progressive worsening of the spine, surgery is considered as an option to relieve that pain.
The goal of scoliosis surgery is to straighten and balance the spine, with respect to both the frontal and side planes, and to achieve this, screws are placed in the vertebrae that are joined together with metal rods. At Instituto Clavel, we are pioneers in Spain in customizing these rods to measure for each patient, as part of our planning of the surgery. To do this, we use specialized software that allows us to simulate the correction of the spinal column that we want to achieve during the operation.
In addition, thanks to intraoperative monitoring , we are able to significantly reduce the risk of neurological damage, so surgery is much safer.
How does scoliosis affect children and adults?
Types of scoliosis
In most cases of scoliosis, the doctor cannot determine its exact cause, and in these circumstances, it is referred to as idiopathic scoliosis. However, when several people in the same family suffer the condition, it is suspected that there may be a genetic component.
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Idiopathic scoliosis: in 80% of cases, the origin of the condition is unknown. There are three types of idiopathic scoliosis
- Infantile: Scoliosis present from birth and up until 3 years of age, is considered infantile. The curvature usually goes away as the child grows.
- Juvenile: occurring in children between the ages of 3 and 10.
- Adolescent: appearing between the ages of 10 and 18. Idiopathic adolescent scoliosis is the most common type of scoliosis and is more prevalent in girls.
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Congenital scoliosis: This type of scoliosis appears during fetal development. Often it is due to vertebrae that did not form normally or are altogether absent.
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Neuromuscular scoliosis: Directly associated with many neurological conditions, neuromuscular scoliosis is spoken of in some cases where children suffer from cerebral palsy, spina bifida, muscular dystrophy, or spinal cord tumors, among other conditions that prevent children from walking.
More information about scoliosis
Treatment for scoliosis
The treatment of scoliosis depends on the age of the patient and the degree of curvature. During adolescence, in cases of mild scoliosis where the curvature of the spine is slight, usually the doctor will recommend periodic checkups to monitor the progress of the condition, and a physical therapist will prescribe certain exercises.
When the curvature is moderate, or appears to progress rapidly between one checkup and another, the doctor will recommend use of a scoliosis brace. Depending on the case, the patient may need to wear the brace almost around the clock (between 20-22 hours), or only at night. However, when the deviation of the spine is so serious that it is disabling, then, as we mentioned earlier, surgery is indicated.
If the patient is an adult, the approach is different. The main objective in adults is to treat the pain caused by the scoliosis so that the patient can enjoy a normal quality of life. If this cannot be achieved with medication, or the curvature is very severe, then we can evaluate the possibility of surgery to correct the spine. The use of a brace is not indicated for adults because it will not prevent the curvature of the spine from continuing to progress.
At Instituto Clavel, we treat both adolescent and adult scoliosis. If you have any questions about scoliosis surgery, you may find the answers here in this article we have prepared for our patients.
Scoliosis surgery: frequently asked questions
Categories: Spine treatments, Spine pathologies, Prevention