Learn About Scoliosis
What is Scoliosis?
Scoliosis is a sideways curve of the spine that shows up as an “S” or “C” shape rather than a straight line down the back. It can occur in children, adolescents and adults. According to the American Academy of Orthopedic Surgeons, approximately two percent of the population has scoliosis.
Symptoms vary with age and severity of the curvature. Many people have some degree of curvature of the spine, or scoliosis, yet experience little or no discomfort. Those with more severe scoliosis may experience back pain, disfigurement and nerve compression that can cause numbness, weakness and leg pain, especially upon standing or walking.
Scoliosis in adults is classified into two main types:
Type I / Progressive Scoliosis – A type of scoliosis that starts out mild or non-symptomatic in young adults but worsens with age due to degenerative changes in the spine.
Type II / Adult Scoliosis – Scoliosis that begins in adulthood in response to degenerative disease of the spinal column. This type of scoliosis can progress at a much more rapid pace than in Type I Adult Scoliosis.
Scoliosis is usually diagnosed by a combination of physical examination and specialized X-rays.
During the physical examination, the physician looks for the degree of rotation in the curvature of the spine as well as secondary changes in other parts of the body that may include:
- Uneven shoulders
- Rib hump or asymmetry
- Low back hump or asymmetry
- A change in the shape of the waist
- Uneven pelvic bones or hips
Frequently, these changes are not visible in a person while they are standing, but become noticeable when the person bends forward.
X-rays are important for pinpointing the shape and location of the curvature as well as for measuring the degree of the curvature so it can be classified.
Treatment decisions are based upon a combination of factors: The degree of curvature, curvature location, risk of progression, spinal imbalance, underlying disease progression and degree of pain the patient is experiencing.
While many with scoliosis mistakenly believe there is no treatment option available to them or that as an adult their scoliosis cannot be treated, Baylor Scott & White Scoliosis Centers offers new hope.
Great advances in the diagnosis and treatment of scoliosis have been made in recent years and the surgeons on the medical staff of Baylor Scott & White Medical Center - Plano offer each scoliosis patient advanced treatment. To date, we have treated more than 3,000 patients with a success rate few others can claim.
At Baylor Scott & white Scoliosis Centers, we also understand that our patients are dealing with more than the physical challenges of scoliosis. They are coping with the emotional challenges as well. One of the most powerful ways we’ve found to help patients considering scoliosis surgery is to hear other people’s experiences.
In most cases, treatment for adult scoliosis begins with a combination of non-operative therapies that may be administered for weeks to months. These include:
- Observation - Many individuals we see do not require surgery to correct their condition. Pediatric patients in particular need to be observed closely before and during their adolescent growth spurt to identify curves that are progressing rapidly and those that remain stable over time.
- Bracing - For large curves in skeletally immature children or curves that have worsened in a child who is still growing, we commonly recommend braces. In many cases a brace can reduce the chance that a childhood curvature will progress to the point of requiring surgery. School scoliosis screening programs are often helpful in catching problems early so that braces can be effectively utilized. However, once adulthood is reached, there is little evidence that wearing a brace will halt the progression of a curvature.
- Spinal rehabilitation - Physical therapy is often needed to stabilize the spine. Pilates can also be helpful for core strengthening. While physical therapy has not been shown to alter the rate of curvature progression in either adult or pediatric patients, strengthening and conditioning programs often help improve back pain. If surgery should ultimately be required, these physically fit patients often have an easier time recovering.
- Pain management - Anti-inflammatory medications and mild narcotics can be administered via injections to help relieve back pain.
- Epidural steroid injections - These types of injections can be helpful in relieving the leg pain that occurs as a result of scoliosis.
For scoliosis patients who are experiencing an increase in curvature and are in pain, surgery may be needed. Scoliosis surgeries are serious and complex with multi-step procedures. For pediatric scoliosis patients, these procedures usually take between two and three hours. Adult surgeries take longer, usually from four to six hours. Adults sometimes need more than one procedure—one performed from the front and one done from the back. Typically, this can be done in one operation, but there are times when two operations are necessary.
Learn more about the different stages of scoliosis surgery: