All of us have a natural curve to our spines, where it curves out at the neck, in at the thoracic area, and out again in the lumbar spine. These curves can become pronounced in conditions such as spondylolisthesis or ankylosing spondylitis, putting pressure on the spine and leading to further degeneration, deformity, and pain. Looking at the spine from the front or back should reveal no curves however, and scoliosis is a spinal condition that creates C-shaped or S-shaped curves where the spine should appear straight. These sideways curves may be quite subtle and cause few problems, but they can also cause pronounced curvature and lead to pain, dysfunctional movement, and difficulties with other normal physiological functioning such as breathing or digestion.
Scoliosis in Children
Scoliosis, referencing the Greek word meaning ‘crooked’, is often associated with children and adolescents, but it can affect adults too (normally due to going undetected in childhood). When young, a child with signs of scoliosis may be given a brace to wear to attempt non-surgical correction of the spine. This brace may help to encourage the spine to grow straight and for the structural ligaments, tendons, muscles, and bones in the back to create a more natural curve front to back, rather than side to side. For older children and adults this bracing is unlikely to be of much assistance other than support as the spine is usually fairly fixed in structure. Similarly, those with extreme abnormal curvature may find bracing ineffective and be advised to undergo back surgery more quickly. This can be especially frightening for younger children, as they can feel self-conscious due to the diagnosis and fearful of the operation itself. Early treatment is, however, very important as it gives the child a better chance at correcting the problem before it becomes too pronounced.
Problems Associated with Scoliosis
More pronounced spinal curvature with scoliosis can lead to problems with the cardiopulmonary system ad require more immediate surgery. Alternative techniques, such as ribcage expanders, may be appropriate in younger children. Most scoliotic curves occur in the thoracic spine and are treated through posterior spinal surgery using fusion techniques. Correction rates are usually around 50% for back surgery for scoliosis. For patients with curvature in the thoracolumbar region an anterior surgery may be the preferred option as more segmental motion may be retained in this procedure which can reduce later complications such as arthritis and pain development. Thoracoplasty alone, or in conjunction with either of these surgeries, involves the removal of ribs for bone grafting purposes or to correct a rib hump deformity. The ribs grow back, usually straight, in alignment with the corrected spine. As there are many potential courses of treatment for scoliosis, patients, and parents of younger patients with the condition are encouraged to discuss their options thoroughly and take time to make their decision as most cases do not require immediate action unlike some other spinal conditions where nerve function may be significantly compromised through treatment delays.
Continued Reading: Symptoms of Scoliosis