In this blog we are going to discuss scoliosis. We will cover the definition, when to provide treatment, types of treatment, when to be concerned and when to not be worried about the diagnosis.
Scoliosis as defined by the American Association of Neurological Surgeons is a spinal curvature in the coronal (frontal) plane. The coronal plane refers to observing a left and/or right curvature in the spine. The curves typically are classified as an S- or C-shaped curvature. These are exactly like you would think. If the spine is shaped like a C, then it is called a C-shaped scoliosis. If it is shaped like an S, then it is an S-shaped scoliosis.
Basic screening for scoliosis takes place in grade school by the school nurse and during medical checkups with the child’s pediatrician. The screening is simple and non-invasive. The child has his or her spine exposed to view, faces away and bends forward at the waist. Abnormalities are observed and recommendations are made if a curvature is suspected. A radiograph of the spine would then be performed. The spine is measured using a Cobb angle, and the severity of the scoliosis can be determined based on this measurement.
Several things may happen if it is determined that there is a scoliosis. If the curvature is classified as mild, a follow-up radiograph of the spine will be taken a few months later to see if the curve is progressing. If the curve is considered to be moderate or severe, then assessment of organ function will take place because some complications of scoliosis are not just with the spine. As the spine curves, pressure and stress can be placed on the organs. Lung function is one organ that is routinely assessed in cases of severe scoliosis.
Treatments for scoliosis range from simply monitoring the progression to surgery. For people with minor curves, and the follow-up radiographs do not reveal any progression of the curve, there is typically not much in the way of treatment provided. These people typically can perform their daily activities without any organ dysfunction related to their scoliosis.
If organ function is determined to be normal, rehabilitation and active therapy are recommended for people with a more moderate scoliosis who have curves that are showing progress from follow-up radiographs to people with initial moderate curves measured by the Cobb angle. Rehabilitation would likely include bracing, and therapy would include stretching and strengthening of the soft tissues involved in scoliosis. Both may help in reducing the progression of the curve in some cases.
The third category is people with severe scoliosis, which affects the organs. This group of people may end up undergoing surgery to stop the progression of the scoliosis. The purpose of the surgery is not necessarily to straighten the spine but to reduce organ dysfunction that distortion of the spine produces. These surgeries, when performed on the right patients for the right reasons, can be successful in improving health and reducing long-term organ problems.
Scoliosis is a complex problem and needs to be identified early so proper treatments may be given. The providers at Advanced Center For Pain And Rehab are trained to identify and treat scoliosis. We are also trained to identify when scoliosis cases need to be referred to a surgeon. Please do not hesitate to contact our office if you have any questions about scoliosis.