Scoliosis is an abnormal rotation of the spine, bending to the left or right into an S or C shape, and the amount of curvature can vary from slight to severe.
Scoliosis usually affects young children and adolescents - a curvature can develop rapidly during growth spurts. It can also occur in elderly patients, known as degenerative scoliosis, due to wear and tear on the back.
In most scoliosis cases (about 80%), the cause is unknown. However, scoliosis can be secondary to a different condition, particularly those that affect nerves or muscles in the back such as muscular dystrophy or cerebral palsy. It can also be genetic and run in families.
Often the only symptoms in children are the appearance of the back:
- Noticeable change in posture
- Clothes hang unevenly
- One shoulder may be higher than the other
- One shoulder blade sticks out
- One hip is more prominent
- Ribs may stick out on one side (if curve is in the upper back). This is known as a rib hump.
It's more likely to cause symptoms in adults caused by the nerves in the spine being compressed, including:
- Back pain
- Shooting nerve pain
- Physical examination and observation
- X-ray of the spine
The severity of the curve is measured in degrees, known as the Cobb angle.
Most cases of scoliosis are mild, with the curve of less than 20° that does not get worse. Most patients just need regular check-ups, especially during periods of rapid growth, to monitor any progression.
In cases where the curve is more than 20° in children who have not finished growing, wearing a back brace can help. It will not correct the scoliosis but can prevent it getting worse.
In severe cases, especially if the child is still growing, surgery may be necessary to straighten the spine. If a curve is over 40°, it is likely to progress by 0.5-1° a year after skeletal maturity, so it is easier to correct at a younger age before the deformity becomes fixed.
This is the most common technique to treat the deformity, where the affected bones are straightened then fused (joined) together using metal rods and screws fitted to the spine.
Most patients spend between 5-10 days in hospital after the operation. Children can normally return to school after 4-8 weeks. The spine is weaker than normal for a few months while the bones continue to fuse but all everyday activities can resume after about 6 months and sport after a year.
"Now I get out a lot more, do more active things and have a lot more confidence. I am so thankful that Mr Rai was able to help me and make me so much happier with myself."
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