SCOLIOSIS
Overview:
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A normal spine will be viewed to be straight. Scoliosis is a condition where there is a side-to-side curve seen in the spine. The curve generally resembles an “S” or a “C.” Additionally, the vertebrae may be rotated. When an individual has scoliosis they will often look like they are leaning to one side.
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Types:
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Nonstructural Scoliosis: A temporary curvature due to an underlying condition. For instance, this can be caused by inflammatory issues, muscle spasms, or different leg lengths. Once the underlying condition is corrected, scoliosis will generally resolve.
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Structural Scoliosis:
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Idiopathic Scoliosis - This type is the most common form of Scoliosis. The cause is unknown but generally is in childhood.
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Degenerative Scoliosis - This type normally presents itself in the aging population and results from deteriorating intervertebral discs.
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Neuromuscular Scoliosis - This type occurs in individuals who cannot walk due to neuromuscular disorders such as cerebral palsy, spina bifida, or muscular dystrophy.
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Congenital Scoliosis: A rare condition that occurs in utero during the developmental process.
Symptoms:
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Back pain and fatigue
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Differences in shoulder height and shoulder blade position
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Differences in hip height
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Severe Scoliosis can make it difficult to breathe as well as put pressure on neurological structures
Diagnosing:
To diagnose, your doctor will perform a clinical exam and ask you a number of questions regarding your symptoms. Your doctor may look for abnormalities via a physical examination, X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI).
Treatment:
Based upon the severity of the condition. Scoliosis is generally treated symptomatically.
When the curve is less the 20 degrees, non-surgical intervention is the first choice and may include:
1. Medications (anti-inflammatories, muscle relaxants, steroids)
2. Physical Therapy (core strengthening, stretching, soft tissue release)
3. Steroid Injections (epidural, facet blocks)
When the curvature is between 25-50 degrees, the doctor may recommend a brace to help straighten out the spine and relieve pressure. Bracing works well in idiopathic scoliosis while the child is still growing.
Surgery is generally required for a curvature greater than 50 degrees. Surgical intervention may be necessary to prevent the curvature from getting worse. Generally, a spinal fusion will be recommended.