What is Scoliosis?
Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone.
The normal shape of a person’s spine includes a curve at the top of the shoulder and a curve at the lower back. If your spine is curved from side to side or in an “S” or “C” shape, you might have scoliosis.
Scoliosis is about two times more common in girls than boys. It can be seen at any age, but it is most common in those over about 10 years of age.
What causes Scoliosis?
Common causes that doctors may identify include:
- Cerebral palsy, nervous system disorders that affect movement.
- Birth defects that affect an infant’s spinal bones.
- Spinal injuries or infections
Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curves from one generation to the next.
Does a person with Scoliosis need a surgery?
If the curve is greater than 45-50°, it will very likely get worse, even after the person is fully grown. This may increase the cosmetic deformity in the back, as well as affect the lung function. Surgery is recommended.
Curves between 40° and 50° in a growing child fall into a grey area — several factors may influence whether surgery is recommended. These should be discussed with your surgeon. Spinal fusion is very successful in stopping the curve from growing. Today, doctors are also able to straighten the curve significantly, which improves the patient’s appearance.
Types of Scoliosis
There are several types of scoliosis:
- Idiopathic scoliosis: Accounts for about 8 in 10 cases of scoliosis. This type of scoliosis typically presents during adolescence, but it can also start earlier in childhood or infancy.
- Degenerative scoliosis: Adult scoliosis is a common condition that occurs later in life as the joints in the spine degenerate.
- Neuromuscular scoliosis: Sometimes develops in individuals who cannot walk due to a neuromuscular condition such as cerebral palsy.
- Congenital scoliosis: Develops in utero and is present in infancy. A rare condition, affecting 1 in 10,000, it can result from malformations in the vertebrae or other causes.
Spinal fusion- Treatment for Scoliosis
During the surgery, an incision is made in the middle of the back. The muscles are moved to the side to expose the spine. The joints between the vertebrae are removed to loosen them up. The vertebrae are roughened up so that the body responds by producing new bone. The new bone eventually bridges the gaps between the vertebrae and makes them fuse together. Metal implants – rods, screws, hooks or wires – are put in to hold the spine still while the vertebrae fuse.
The fusion is augmented with bone graft. This may be obtained from the patient – known as “autogenous” bone graft and harvested typically from the pelvis, or it can be from a bone bank from a donor – known as “allogenous.” The patient or the patient’s parents decide on whether to go ahead with the surgery after a careful discussion of the benefits and risks with the orthopedic surgeon.
Spinal fusion surgery usually takes four to six hours, but the time varies according to the individual patient. The surgeons will take as long as they need to do the job well.