What is Scoliosis ?

There are various terms in the spine which confuse us. These include Kyphosis lordosis scoliosis etc.

Scoliosis is not a new disease. It has been troubling mankind since eternity. The term refers to a sideways abnormal bent in the spinal bones of a person. In the modern world the written records of scoliosis dates back to as far as 3500 BC by Hippocrates.

Generally speaking scoliosis starts to manifest in the first two decades of life and then progressive changes may lead to symptoms which require the attention of a medical professional.

Symptoms of Scoliosis

During the early onset of scoliosis the patient or the close contacts including the immediate family, relatives and the friends do not notice any symptoms. This is attributed to the nature of the disease as it has very silent in onset and has a slow progression. Generally patient comes to know about scoliosis when he is noticed by someone bare chested. This would include family, friends, playmates etc. However there are few clear cut scoliosis symptoms which help in the establishing the existence of scoliosis in a person. .

These Include:

    Discrepancy in the level of both the Shoulders. In a scoliosis person one shoulder may be higher up than the other shoulder depending upon the type of scoliosis he has.

    Abnormal prominence of shoulder blade. the person will have abnormal prominence of one shoulder blade than the other which will be seen clearly from the back of the patient.

    The curvature off the midline of spine seen from the back may Bent towards one side. The site of curvature also depends on whether patient has lumbar scoliosis or thoracolumbar scoliosis. 

    IN scoliosis patient may also have abnormal rib hump on one side because of the rotation of the spine.

     Abnormality in the level of hip joints

Causes of Scoliosis

Now the most important question is why my child has scoliosis and what are the scoliosis causes ? To answer that kind of question we have to understand that the human body is an incredibly complex creation of nature with an incredibly complex mechanism which makes it grow during the childhood, adolescence and adulthood. This is to be noted that majority of scoliosis cases around the globe are idiopathic in nature however some can be attributed to different causes.

This also leads us to types of scoliosis causes.

• Idiopathic Scoliosis

• Associated with some other birth defects

• Associated with other Skeletal disorders (ex Limb Length Discrepancy)

• Hereditary causes. 

Risk Factors in Scoliosis

There are a few risk factors which can be attributed to causing scoliosis however no one can definitely say that this person will develop scoliosis because of these risk factors.This factor includes Association with some neuromuscular disorders. scoliosis is known to run in some families and thus being born in that family entertains risk of scoliosis.There are few other reasons which involve secondary reasons for scoliosis like age related degenerative changes of spine in an elderly patient, severe osteoporosis leading to sideways collapse of spine etc. 

Treatment of Scoliosis

Scoliosis Treatment of the scoliosis generally depends upon the the degree of scoliosis, the age at which patient has presented to a Spine Surgeon, and also the amount of complications the scoliosis is currently causing and is supposed to cause in near future.

However the treatment of scoliosis can be grouped into to handful of options which are Observation, Bracing & Scoliosis Surgery discussed under:

1. Observation: if scoliosis spine is very mild, also called as mild curve or simply put Mild scoliosis, and it is not progressive in nature all what is recommended from spine surgeons is to observe the disease and get a regular examination by the treating spine expert. Obviously that would involve getting periodic Scoliosis radiology Xrays and if the expert desires other scans including CT scans and MRIs can be done. This aides spine surgeons to accurately calculate the extent of disease and also to understand the speed at which it is progressing or it is keeping stable. scoliosis exercises are also taught to the patient.

2. Bracing:  Functional bracing of the body is done when the surgeon thinks that the curve may progress and may lead to complications. There are various kind of custom made sciloisis braces which may somewhat restrict the progress in the scoliosis meaning arresting curve by providing a strict support to the torso. Types of brace recommended by an expert depends upon whether there is scoliosis of lumbar spine of thoracolumbar spine.. For Example TLSO Brace.

3. Surgery: Scoliotic curves which are greater than 40 Degrees in angle or which are impending to cause complications and future generally need surgical interventions which include Scoliosis correction surgeries and fusion. In these patients detailed preoperative planning is done in order to assess the amount of spinal levels requiring fusion and then the scoloisis surgery is done special Neuromonitoring System. This includes pedicle screw fixation and gradual realignment of the spine in the operation theatre. The aim of surgery is to correct as much as possible the amount of curvature of spine and also to to make sure that the curve does not progress in the future.Thus avoiding future complications. 

Conclusion of Scoliosis

Until last Decade the treatment of scoliosis was considered as very complex major surgery which includes high risk to the spinal nerves and high chances of paralysis.However since the availability of various high end technologies in the operation theatre things have dramatically changed. one such technology is called a neuromonitoring system. This neuromonitoring system enables the doctor to real-time check the activity of nerves in the operation theatre and the chances of having a paralysis because of accidental injury to the nerve is very significantly reduced as any minor insult to the nerve is immediately reported by the neuromonitoring system. Needless to say, now this surgery has become fairly common and relatively safer than previously Decades.