Scoliosis Treatment in New Jersey
The National Scoliosis Foundation reports that scoliosis affects 2 to 3 percent of the population, somewhere between six to nine million people in the United States. Scoliosis is most often discovered in children between the ages of 10 and 15 years old. It Is more common in girls than in boys.
What Is Scoliosis?
Scoliosis is an orthopedic condition that is identified by the abnormal curvature of the spine. Whereas a typical spine would appear straight when viewed from behind, a spine affected by scoliosis would appear curved in the upper, mid, or lower back. This curvature can either be “C-shaped” or “S-shaped” and in some cases, the vertebrae may also be twisted or rotated. Most cases of scoliosis are detected in childhood and adolescence, however, some patients are diagnosed in adulthood.
Most cases of scoliosis have a curvature of less than 25 degrees and only require observation.
Scoliosis may accelerate during a rapid growth period and may worsen later in life, if untreated. Scoliosis symptoms may vary based on the type and severity of their condition.
Although most causes of scoliosis are unknown, some cases may be genetics, the result of a previous injury, or a symptom that is associated with another condition, such as cerebral palsy or muscular dystrophy.
What Are the Common Types of Scoliosis?
Scoliosis types are generally grouped by etiology, or cause.
- Congenital scoliosis. This type of scoliosis is the result of an embryological malformation or birth defect. Abnormalities in the vertebral column cause one portion of the spine to develop at a different rate, which results in a curvature of the spine. Because this condition is present at birth, it tends to be diagnosed during puberty.
- Neuromuscular scoliosis. This type of scoliosis is caused by other neurological or muscular diseases, such as spina bifida, cerebral palsy, muscular dystrophy, or spinal cord trauma. This scoliosis type often requires surgical treatment as it tends to develop more rapidly.
- Degenerative scoliosis. This form of scoliosis typically impacts the lumbar region, or lower back and affects individuals aged 65 and older. It is generally diagnosed alongside spinal stenosis, or narrowing of the spinal canal, and is associated with painful pinched nerves.
- Idiopathic scoliosis. An idiopathic diagnosis is assigned when all other causes are ruled out. Most types of scoliosis, such as adolescent scoliosis, are considered idiopathic, with an unknown cause.
What Are the Symptoms of Scoliosis?
Scoliosis is often identified by the following appearances and traits:
- Slouched appearance or raised hump on the back
- Abnormal gait or difficulty with walking
- Tendency to lean to one side of the body
- Limited range of motion of the back and spine
- Uneven shoulders or the appearance that one is higher than the other
- Uneven hips or the appearance that one is higher than the other
- Having one shoulder blade that is more prominent than the other
- Mild to moderate back pain
- Difficulty breathing, in severe cases
What Are the Risk Factors for Scoliosis?
Although the cause of scoliosis is often unknown, it does tend to occur among the following individuals.
- Females. More females than males are likely to develop idiopathic scoliosis, the type that is caused by unknown origins.
- Heredity. Those who have one or more family members with scoliosis are more likely to develop scoliosis.
- Injury and infection. Those who have suffered a chest wall or spinal injury or an infection of the spine have an increased chance of developing scoliosis.
- Other conditions. Those born with spina bifida, cerebral palsy, muscular dystrophy, spinal cord injury, or other birth defects that affect bone and spine development are likely to be born with or develop scoliosis.
Diagnosing Scoliosis
When a person exhibits multiple symptoms of scoliosis, they should proceed with a medical consultation to get a diagnosis. A scoliosis screening involves a physical examination, during which time a patient is asked to bend forward 90 degrees from the waist. From this position, the clinician may determine whether the patient’s shoulders, hips, or ribs are misaligned. When abnormalities are observed, the clinician will proceed with scheduling additional tests, which may include:
- X-ray. Special X-rays that allow a full view of the spine from top to bottom help the physician see the entire curve and deformity.
- Computed tomography scan (CT or CAT scan). This computerized technology can capture a highly-detailed, diagnostic image of the spinal canal and its surrounding structures.
- Magnetic resonance imaging (MRI). Through the use of magnets and computers, this diagnostic test can capture three-dimensional images of the spinal cord, nerve roots, and surrounding structures, as well as signs of abnormalities.
With this imagery, the physician can observe and measure the degree of the spinal curvature, if present. A positive diagnosis is identified by a curvature of greater than 10 degrees. A curvature greater than 25 to 30 degrees is considered significant in an adolescent who is still growing and may indicate the need for bracing. In an adolescent who is still growing, a curvature exceeding 45 to 50 degrees may indicate the need for surgery.
Scoliosis Treatment in New Jersey
As the largest health system in New Jersey, RWJBarnabas Health offers comprehensive medical care for the entire family. Our well-rounded orthopedic department is led by highly trained orthopedic surgeons, physicians, physician assistants, registered nurses, physical therapists, and medical professionals who will guide you through your scoliosis treatment process with care and compassion.
Scoliosis treatment may depend on a variety of factors, such as:
- Patient’s age. Is he or she still growing and maturing?
- Severity of curvature. How pronounced is the curve? Does it impact the patient’s lifestyle?
- Likelihood of curve progression. Patients who are diagnosed with a significant curvature before their adolescent growth spurt are more likely to undergo curve progression.
Based on the factors above, a patient may proceed with the following treatment options:
- Observation. Many cases of scoliosis are mild enough to not require treatment. Although scoliosis doesn’t typically go away on its own, some cases may be observed for a period of time, to determine whether the curvature progression has stopped.
- Bracing. A specially-fitted scoliosis brace can be an effective treatment for patients who are still growing and have a moderate curvature. To correct the curvature, a brace typically must be worn a minimum of 16 hours per day until the growth period ends.
- Halo-gravity traction. This technique is used to correct severe spinal deformities by stretching and straightening the spine.
- Physical therapy. Physical therapy uses exercises to help the patient work on posture, breathe more effectively and help the spine return to a more balanced position.
- Surgery. Surgery is typically an option for severe cases of scoliosis for patients who have a curvature of greater than 40 degrees and are still progressing. Surgery may be approached from the back or front, and often involves some form of spinal fusion, or the use of bone grafts to weld the affected vertebrae together. It can take approximately three months to heal from spinal surgery, with full recovery taking up to one year.
Other specialized surgeries include:
- MAGEC rod and other growing rods. Implantation of rods serves to lengthen the spine with the help of remote control and powerful magnets.
- Vertical expandable prosthetic titanium rib (VEPTR). This FDA-approved device is used to treat thoracic insufficiency syndrome (TIS) in children. Through the use of an implanted metal rod, it straightens the spine to allow the lungs to grow and expand.
In addition to these treatments , many people with scoliosis find pain relief in healthy practices and therapies such as light exercise, stretches, massage, heat therapy and maintaining a healthy weight.
Do you suspect you or a loved one may have scoliosis? Schedule a consultation with one of our orthopedic physicians today.
