Scoliosis

The signs of scoliosis may include

• Uneven Shoulders
• One Shoulder Blade Appears More Prominent Than The Other
• Uneven Waist
• One Hip is Higher Than The Other
• Loss of Height

Symptoms of scoliosis may include

• Bumps in the Lower Back
• Numbness, Weakness, or Pain in the Legs
• Trouble Walking
• Trouble Standing Up Straight
• Feeling Tired
• Shortness of Breath

Idiopathic Scoliosis. In 80-85% of cases, it is not known what caused the child to develop scoliosis. This is known as idiopathic scoliosis. Scoliosis tends to run in families, but there are no known ways of preventing it. Poor posture does not cause scoliosis.

Congenital Scoliosis. In other cases, scoliosis is congenital, meaning the child was born with it. If one or more of the vertebrae do not form completely, or the vertebrae do not separate properly as the spine develops before birth, the child may have scoliosis at birth. Some cases of congenital scoliosis can change very quickly as the child grows, while others remain largely unchanged over time. Children with congenital scoliosis often have other health issues, such as kidney or heart problems, as well.

Neuromuscular Scoliosis. Neuromuscular conditions like cerebral palsy, muscular dystrophy and spinal cord injuries can also cause scoliosis due to muscle imbalance and/or weakness.

Degenerative Scoliosis. This type affects adults and usually develops in the lower back as the disks and joints of the spine begin to wear out as you age.

Scoliosis affects the entire skeletal system including the spine, ribs, and pelvis. It also impacts the brain and central nervous system, as well as the body’s hormonal and digestive systems. 

If moderate to severe scoliosis is left untreated, it can lead to pain and increasing deformity, as well as potential heart and lung compromise.

Initial treatment for scoliosis may be nonsurgical, but if the curvature of the spine is severe or worsens over time, surgery may be considered.

Nonsurgical Scoliosis Treatment. For more minor cases of scoliosis, your doctor may recommend simply keeping an eye on the curve to make sure it doesn’t get worse. However, if the curve is 20-40 degrees when first measured and has increased more than 5 degrees over time, bracing may be recommended to stop the progression of the curve. Bracing may also be recommended for children who have a curve that is more than 30 degrees and still have a lot of growing left to do.

The primary purpose of bracing is to stop the progression of the curve. Bracing is typically done until the patient has stopped growing, at which point the curve is much less likely to get worse.

Braces for scoliosis can be made of rigid plastic or soft elastic material. The type of brace needed will depend on the positioning of the curve, the flexibility of the curve, and how many curves there are in the spine. The child’s lifestyle and activities will also be considered when choosing a brace.

Depending on the curve and the child, Dr. Ball may recommend a brace that can be worn as little as 8 hours a day, while the child is sleeping. Braces designed to be worn during the daytime may be worn for a longer period of time. The longer the brace is worn, the less likely the patient is to need surgery in the future. Your doctor will advise you on how and when to wear your brace. Typically, you will have to see your doctor approximately every 6 months to re-evaluate your condition. 

Surgical Treatment for Scoliosis. Surgery is typically recommended for patients with 45-50 degree curves in the spine, or for patients whose curves get worse over time.

Surgical treatment for scoliosis involves spinal fusion. During this procedure, Dr. Ball realigns the spine and fuses the curved vertebrae together. The fused vertebrae heal together, creating one solid bone. This can greatly reduce the curve in the spine.

Rods, screws, and cages are used to hold the fusion in place, and are typically not removed after the bones have fused. 

Patients will typically need to stay in the hospital for a few days after a spinal fusion but are typically able to walk the day after surgery. Children who have undergone a spinal fusion may need to stay home from school for 2 to 4 weeks. Patients will also need to avoid certain activities while the spine heals. Heavy lifting and bending forward should be limited as much as possible for the first 6-12 weeks. Patients are able to resume exercise and sports activities within 3 months of surgery, but contact sports should be avoided until the spine has fully healed. A complete, solid fusion of the spine is typically achieved within 6-12 months of surgery.

The fused portion of the spine will be immobile, but Dr. Ball will fuse only the vertebrae that are necessary and safe to reduce the curvature. This will allow you to retain motion in the unfused parts of the spine. Once fully healed, patients are able to participate in most activities, but may need time to adapt for some activities.

At CalSpine MD, Dr. Ball specializes in the treatment of scoliosis. If you think your child may have scoliosis and you would like an evaluation, please call (925) 667-3565 to schedule an appointment. You may also request an appointment online.