It’s normal for your spine to curve a little bit, but a spine that curves too much is a condition called scoliosis. This abnormal curving of the spine is often bent into the shape of the letter C or S.
What causes scoliosis?
The most common type of scoliosis is called idiopathic scoliosis, which means that its cause is unknown. It is divided into categories based on age:
- Infantile scoliosis affects children ages 3 and younger
- Juvenile scoliosis affects ages 4-10
- Adolescent scoliosis affects ages 11-18
Scoliosis affects girls more often than boys, and the spinal curvature usually worsens during a growth spurt. The other types of scoliosis are congenital, which is present at birth, or neuromuscular, which is related to a nervous system problem like cerebral palsy or muscular dystrophy.
What are the symptoms?
In many patients, there are no scoliosis symptoms. In some cases, however, patients may experience back pain, uneven hips or shoulders, or fatigue in the back after standing or sitting for long periods.
How is it diagnosed?
Routine screening for scoliosis is performed in middle schools, helping to detect the problem in many young people. If the health care professional notices an issue at that time, or if you suspect scoliosis in yourself or someone else, seeing a physician is recommended. Dr. Fischer at NYU Langone Medical Center in New York City is experienced in diagnosing and treating scoliosis patients. While looking at your spine, the doctor will ask you to bend forward. This makes your spine easier to see, sometimes allowing a curve to be detected. The physical exam will also allow the doctor to look for one shoulder higher than the other, or a tilted pelvis. Spinal X-rays are taken to fully see any curves and identify the extent of the curves, and spinal curves will be measured. An MRI may also be part of the diagnostic process for scoliosis.
How is it treated?
Treatment depends on the type of scoliosis, location of the curve, size of the curve, and stage of body growth. Many idiopathic scoliosis patients do not need treatment, although should be monitored over time to make sure. If you are still growing, a back brace to prevent additional curving may be advised. Braces work best in patients over age 10, and only in idiopathic cases. There are various options for braces today, many of which are much less cumbersome and uncomfortable than previous scoliosis braces. A qualified physician like Dr. Fischer will recommend the best type of brace for your condition.
Severe or rapidly progressing curves may require surgery. The curve will typically be corrected using metal rods to secure the spinal bones, also using screws and hooks until the bone heals. An incision is required through the back, under the ribs, or through the abdomen. Scoliosis surgery and recovery can be quite difficult, so it is usually the last resort for curve correction.
What is the long-term prognosis?
Idiopathic scoliosis often does not cause long-term problems, especially if it is mild or when it is identified and treated early. Back pain can occur as the patient ages. Congenital or neuromuscular scoliosis may have a worse prognosis, especially when other serious health conditions are involved. Experienced physicians like Dr. Fischer at NYU Langone Medical Center can help provide the best long-term results for scoliosis patients.
Contact Dr. Fischer today to schedule your appointment.