FAQ
Most frequent questions and answers
Scoliosis frequently affects children and adolescents, presenting as a lateral curvature of the spine that exceeds 10 degrees on an X-ray.
Rather than aligning straight down the back, the spine of a person with scoliosis curves, often forming a “C” or “S” shape.
This condition can also involve slight rotation of the vertebrae, which may lead to an uneven appearance of the waist or shoulders.
In over 80 percent of cases, the exact cause of scoliosis remains unknown, and these instances are classified as “idiopathic,” which means “of undetermined cause.”
However, scoliosis can also arise from various known conditions, including congenital spinal abnormalities (vertebrae that are abnormally formed at birth), neurological disorders, muscular diseases, genetic conditions such as Marfan syndrome or Down syndrome, and numerous other factors like spinal infections or fractures.
There are numerous prevalent misunderstandings exist regarding scoliosis. However, it’s crucial to correct the record: scoliosis is not caused by carrying heavy backpacks or other weighty items, engaging in athletics, adopting poor sleeping or standing positions, insufficient calcium intake, or minor discrepancies in leg length
Children can have their spines checked for scoliosis at any age, but it’s often noticed more during growth spurts, typically between 10 to 15 years old.
The Emirates Scoliosis Club suggests that girls should have two check-ups, at ages 10 and 12 (which are usually in grades 5 and 7), and boys should have one check-up at age 12 or 13 (usually in grades 8 or 9).
Some schools might already have programs to screen for scoliosis among these groups of children. However, if you think your child has poor posture, it’s best to have them checked by qualified healthcare professionals.
Once scoliosis is suspected, a doctor will typically conduct the following steps to diagnose the condition:
- Medical History: The doctor will inquire about the patient’s medical history, including any family history of scoliosis or related conditions.
- Physical Examination: The doctor will perform a physical examination, observing the patient’s back, shoulders, hips, and ribcage for signs of asymmetry, unevenness, or curvature.
- Measurement of Spinal Curvature: The doctor may use a tool called a scoliometer to measure the degree of curvature in the spine.
- X-rays: X-ray images of the spine are taken from the front and side to provide detailed pictures of the spinal curvature and its severity.
- Additional Imaging: In some cases, additional imaging tests such as MRI or CT scans may be ordered to assess the spine and surrounding structures more comprehensively, especially if there are concerns about underlying causes or complications.
During the examination, the doctor observes the patient from behind and asks them to bend forward until the spine is horizontal. This procedure, known as the Adams test, involves checking for any irregularities or asymmetry in the back, such as a hump deformity of the chest or loin, which can indicate scoliosis. It’s a highly sensitive screening method for this condition and is commonly utilised.
Diagnosis of scoliosis is most effectively conducted by a physician through a comprehensive physical examination of the back. As the patient stands in a relaxed position with arms at their sides, the doctor assesses for signs such as noticeable spinal curvature, shoulder blade asymmetry, uneven waistline, and any trunk shift (body drifting away from the centre). Subsequently, the patient bends forward at the waist, allowing the physician to examine for rotational aspects of scoliosis in the upper (rib prominence) or lower (waist prominence) part of the back.
Scoliosis is typically graded based on the severity of the spinal curvature, usually measured in degrees using a system called the Cobb angle. The Cobb angle is determined by measuring the angle between the vertebrae at the top and bottom of the curve on an X-ray image.
The grading system for scoliosis based on Cobb angles is as follows:
- Mild Scoliosis: Curvature measuring less than 20 degrees.
- Moderate Scoliosis: Curvature measuring between 20 and 40 degrees.
- Severe Scoliosis: Curvature measuring greater than 40 degrees.
This grading system helps healthcare providers determine the appropriate course of treatment and monitor the progression of the condition over time. It also allows for consistent communication among healthcare professionals regarding the severity of the scoliotic curvature.
To the best of our understanding, there is currently no definitive evidence supporting the effectiveness of physical therapy in treating scoliosis. The fundamental change in the shape of the spine stems from abnormal bone growth within the body, a process unlikely to be significantly altered by physiotherapy alone. However, some scientific studies suggest that physical therapy could potentially aid in achieving a straighter posture and improving breathing.
Various physical therapy techniques have been developed to mitigate the impacts of scoliosis and enhance body shape and appearance. Nevertheless, there is limited evidence indicating that physical therapy is more effective than no intervention in preventing the progression of the spinal curve during growth.
If you are experiencing additional spinal issues alongside scoliosis, such as back pain, your healthcare provider may recommend tailored physical therapy to address your specific needs
Not all cases of scoliosis require treatment because the severity and progression of the condition can vary widely. Many individuals with scoliosis have mild curves that do not worsen over time and do not cause significant symptoms or complications. In these cases, the primary approach is often regular monitoring through periodic check-ups to ensure the curve does not progress.
For these individuals, the impact on daily activities, physical appearance, and overall health is minimal, and invasive treatments like bracing or surgery are unnecessary. Instead, non-invasive measures such as physical therapy may be recommended to maintain spinal health and posture.
Thus, the decision to treat scoliosis depends on factors such as the degree of curvature, the age and growth potential of the patient, and the presence of symptoms, ensuring that treatment is tailored to the individual’s specific needs and circumstances.
The long-term impact of not treating severe forms of scoliosis can be significant and varied, potentially affecting both physical health and quality of life.
Here are some key consequences:
- Progression of the Curve: Without treatment, scoliosis can worsen over time. The spinal curve may increase, leading to more severe deformities.
- Chronic Pain: Untreated scoliosis often results in chronic back pain, which might become debilitating and interfere with daily activities.
- Cardiopulmonary Issues: In elected extremely severe spinal curvature can compress the rib cage, restricting lung capacity and making breathing more difficult. This can lead to respiratory problems and, in extreme cases, heart issues.
- Reduced Mobility: As the curvature progresses, it can limit flexibility and range of motion, making it harder to perform physical activities and reducing overall mobility.
- Nerve Damage: Although it hardly ever happens, in really bad scoliosis, the nerves can get squeezed, which might make your legs and feet hurt, feel numb, or get weak.
- Physical Deformity: Increasing curvature can lead to noticeable physical deformities, such as uneven shoulders, hips, or a prominent rib hump, which can affect posture and appearance.
- Emotional and Psychological Effects: Living with untreated scoliosis can impact mental health, leading to issues such as anxiety, depression, and low self-esteem, especially due to physical appearance changes and chronic pain.
- Decreased Quality of Life: The combined physical and psychological effects of untreated scoliosis can significantly reduce an individual’s quality of life, making everyday tasks more challenging and impacting social and professional activities.
Timely diagnosis and appropriate management are crucial to mitigating these long-term effects and improving outcomes for individuals with scoliosis.
A doctor may recommend surgery for scoliosis when conservative treatments such as bracing or physical therapy have not effectively managed the condition, and if the curvature of the spine is severe and progressive. Generally, surgery is considered when:
- Severity of the Curve: The spinal curvature exceeds 40-50 degrees, particularly if it continues to progress despite conservative treatments.
- Growth Potential: In children and adolescents, if the curvature is moderate to severe and the individual has not reached skeletal maturity, brace or surgery may be recommended to prevent further progression and deformity.
- Risk of Progression: If the curvature poses a high risk of progression, based on factors such as age, remaining growth potential, and the degree of curvature.
- Symptoms and Complications: Scoliosis causes significant pain, breathing difficulties, or neurological symptoms due to spinal cord compression or nerve damage.
- Cosmetic Concerns: The curvature of the spine significantly impacts the patient’s appearance and quality of life, leading to emotional or psychological distress.
- Failure of Conservative Treatments: If conservative treatments such as bracing or physical therapy have been unsuccessful in managing symptoms or halting the progression of the curve.
Ultimately, the decision to undergo surgery for scoliosis is made on a case-by-case basis, considering the individual’s age, overall health, severity of the condition, and potential risks and benefits of surgery.
It’s important for patients and their families to discuss treatment options thoroughly with their healthcare provider to make an informed decision.
The objective of scoliosis corrective surgery is to reduce and stabilize the curvature of the spine, thereby improving spinal alignment, posture, and overall function. The surgery aims to:
- Correct the Curve: The primary goal is to reduce the abnormal curvature of the spine to a more normal alignment, thereby preventing further progression and deformity.
- Stabilize the Spine: The surgery involves fusing together the vertebrae affected by scoliosis using bone grafts, rods, screws, or other instrumentation to stabilize the spine and prevent further curvature.
- Relieve Symptoms: For individuals experiencing pain, discomfort, or neurological symptoms due to scoliosis, surgery aims to alleviate these symptoms by decompressing nerves and restoring spinal alignment.
- Improve Function: By straightening the spine and restoring alignment, surgery can improve posture, mobility, and overall function, allowing individuals to engage in daily activities more comfortably.
- Prevent Progression: Corrective surgery helps halt the progression of scoliosis, particularly in children and adolescents who are still growing and at risk of worsening curvature.
- Enhance Appearance: Surgery can also improve the cosmetic appearance of the spine and torso, reducing visible deformity and boosting self-confidence.
Overall, the objective of scoliosis corrective surgery is to improve the patient’s quality of life by addressing the underlying spinal deformity and its associated symptoms, while also preventing further progression of the condition.
Yes, many people can lead normal lives after scoliosis corrective surgery.
The surgery aims to improve spinal alignment, reduce pain, and enhance function and mobility. With proper rehabilitation and follow-up care, individuals can often return to their normal activities, including sports, work, and hobbies. However, the extent to which someone can resume their usual activities depends on various factors, including the severity of the scoliosis, the success of the surgery, and individual recovery.
It’s essential to follow the recommendations of healthcare professionals and engage in rehabilitation exercises to optimise outcomes and maintain spinal health after surgery.
Yes and No.
Scoliosis surgery can potentially have an impact on pregnancy, although the extent of the impact depends on various factors, including the type of surgery performed, the severity of the scoliosis, and individual health considerations.
- Spinal Fusion Surgery: If a woman has undergone spinal fusion surgery for scoliosis, the fusion may limit some of the flexibility of the spine, which could affect the ability to carry a pregnancy comfortably.
However, many women who have had spinal fusion surgery can still conceive and carry a pregnancy to term successfully. - Pain and Mobility: Some women may experience residual back pain or limited mobility following scoliosis surgery, which could impact their ability to engage in certain activities during pregnancy, such as bending, lifting, or standing for long periods.
- Type of anaesthesia: While most women who have undergone scoliosis surgery can still have a normal delivery, some may experience challenges with epidural anaesthesia during childbirth. This is because the spinal fusion surgery performed for scoliosis may alter the anatomy of the spine, making it more difficult to administer epidural anaesthesia. In some cases, scar tissue from the surgery or changes in spinal curvature may affect the placement of the epidural needle, resulting in a lower success rate for epidural anaesthesia.
However, it’s important to note that each woman’s experience may vary, and many women with previous scoliosis surgery still successfully receive epidural anaesthesia during childbirth. It’s essential for women to discuss their medical history and any concerns with their healthcare provider when planning for childbirth to ensure appropriate pain management options are available.