Scoliosis is a condition in which the spine has an abnormal curve. The condition can affect both adults and children. Etiology determines the form of scoliosis: congenital, neuromuscular, degenerative, or idiopathic.

Forms of Scoliosis

Congenital scoliosis is the result of a spinal defect present at birth. When one or more vertebrae form incorrectly, areas of the spine do not grow at the same rate, causing a curvature. Doctors can often diagnose this curvature at a young age.

Neuromuscular scoliosis is a secondary condition to a neurological or muscular disease, such as cerebral palsy, spina bifida, or a spinal cord injury. Muscle weakness caused by these conditions can prevent the spine from growing correctly. Doctors can typically detect this type of curvature at a young age as well.

Scoliosis - Before surgery Degenerative scoliosis, or adult onset scoliosis, is the result of the degeneration of facet joints and intervertebral discs, which are parts of the spine. Degenerative scoliosis is most common in adults over age 65 and progresses with age.

Idiopathic scoliosis is the most common form of scoliosis. It has no definite cause, and doctors diagnose this form after excluding all other forms. Idiopathic scoliosis tends to run in families and most commonly affects girls.

Most scoliosis cases in children are idiopathic. The curvature occurs primarily during the child’s growth spurt, and doctors often diagnose it during puberty. Idiopathic scoliosis can also occur in adults, although it is less common.

In all forms, scoliosis can worsen over time. However, both surgical and non-surgical treatments can help correct the spine’s curvature and relieve one’s symptoms, including pain.

Symptoms of Scoliosis

Experiencing one or more of the following symptoms may indicate the possibility of scoliosis:

  • Uneven shoulders
  • Uneven ribcage
  • One shoulder blade protrudes more than the other
  • Unusually raised hip
  • Head not centered on the body
  • Aching and/or stiffness in the lower back
  • Pain in the mid to lower back that could continue into the leg

If you are experiencing one or a combination of these symptoms, contact your doctor for further examination.

This patient had low back pain and leg weakness from lumbar scoliosis and stenosis.

Scoliosis Front View

Above: Scoliosis, or curvature of the spine, before surgery

Dr. Nkrumah performed wide and extensive decompression from the back to free up the compressed nerves.

Scoliosis correction - side

Above: Xrays showing correction of scoliosis after surgery

Diagnosis

If you or your doctor notice signs of scoliosis, they can diagnose the condition using several methods. They may begin with a physical examination and then run additional tests such as X-rays, a CT scan, or an MRI. These types of tests can confirm scoliosis is present, measure the curvature of the spine, and potentially diagnose the form of scoliosis.

At Nkrumah Neurosurgery, we X-ray the entire spine. Based on the front and side views, we can determine the nature of its curvature and tilt. We may also conduct an MRI of areas that are causing symptoms, such as the lumbar or thoracic spine. We may also conduct a CT scan of the lumbar and thoracic spine to assess bone architecture.

These results, in addition to the severity of symptoms, can help determine a treatment plan.

Treatment Options

Recommended treatment plans will vary by patient but may include the following:

Non-Surgical

  • Observation: If symptoms are mild or nonexistent, observation may be appropriate. Regular X-rays and noting any new symptoms can determine if further treatment is necessary. This is common for juvenile and adolescent scoliosis, as the spine is still developing.
  • Physical Therapy: Certain exercises may help correct spine curvature and/or relieve symptoms.
  • Bracing: Instrumentation, such as a brace, can slowly correct spine curvature over time.
  • Weight loss: If weight is causing or contributing to scoliosis, a weight loss program can prevent further curvature and relieve symptoms.

Surgical

  • Surgical Correction: Screws and rods can make the spine more pliable, releasing areas causing the curvature.
  • Surgical Removal: Removing parts of the bone or facet joints in adults can make the spine more pliable.
  • Spinal Fusion: Fusing vertebrae can fully correct spine curvature. However, spinal fusion is a long surgery with a long recovery, often leaving the spine rigid. Doctors often explore other treatment options before recommending spinal fusion.

Which treatment option is best for me?

Each patient and scoliosis case is unique. Several factors can help determine the best treatment plan for a particular patient with scoliosis.

The level of curvature may influence the treatment plan, as more severe curves may require more immediate treatment. Your doctor will also consider the severity of symptoms. Other factors to help determine a treatment plan may include compression, height changes, weight, bone density, and readiness for surgery.

At Nkrumah Neurosurgery, Dr. Nkrumah will spend at least an hour learning the details of your symptoms and explaining various treatment options in depth. Once you determine a treatment plan, you will still have choices every step of the way to make your road to recovery as smooth as possible.

Contact our office online or call (631) 525-1420 if you have any questions or to schedule an appointment.