Scoliosis Frequently Asked Questions

Scoliosis is characterized by a sideways curvature of the spine. This abnormal curvature may assume an S- or C-shape depending on the case. However, the vast majority of scoliosis cases occur during the major growth spurt that happens during puberty.

The vast majority of scoliosis cases are idiopathic—meaning that the precise cause of the spinal deformity is unknown. Truth be told, there is conflicting evidence regarding whether or not the condition has genetic origins. However, although scientists have yet to isolate a “scoliosis” gene, scoliosis does appear to run in families with a third of patients identified as having a family history of the disorder.

Naturally, the answer to this question depends on the nature of the case. First and foremost, you should listen to the advice of your doctor. If your child has a mild scoliotic curve, there’s a good chance that you’ll be instructed to stand by and wait. More aggressive scoliotic curves may require more proactive interventions. It’s never a bad idea to request a risk assessment to determine where your child’s case falls.

In simple terms, the Cobb angle is the most standardized, widely used measurement that doctors employ to determine the severity of spinal deformities. By examining a radiograph, your doctor will be able to determine the intersecting lines between the two most tilted vertebral endplates. Where these lines intersect is known as the Cobb angle, and it quantifies the severity of the existing scoliotic curves.

They can. It depends on four determining factors:

• • Age
  • Gender
  • Skeletal maturity

Type or shape of the scoliotic curve
Being diagnosed at a young age translates into a higher chance of scoliotic curve progression due to growth spurts. Additionally, some growth plates close at different ages for both boys and girls, which will determine how much growth the child has remaining. Thirdly, girls are much more likely to develop progressive scoliotic curves than boys. Lastly, certain curve shapes have a greater chance of progressing than others. The location of the curve also plays a role in the chance of scoliotic progression.

Though your mileage will always vary, your chances are still best if your doctors catch the spinal deformity in its earliest stages. It is much easier to halt progression than it is to perform major reconstructive surgery. Bracing, while uncomfortable, is an extremely effective form of treatment that can halt scoliotic curve progression. Doctors generally desire to avoid surgery if there are other conservative and applicable means of treatment available to the patient.

Though they can’t cause the condition, activities that involve deep backbends and spinal position alteration may lead to scoliotic curve progression. We’re not saying that you can’t do these certain tasks, just that you should be aware that they may have an effect on your overall condition in the future.

What works best for you will vary on a case-by-case basis. That being said, many people find that sleeping on a high-quality mattress with medium firmness is ideal for those suffering from scoliotic curves. Additionally, you shouldn’t sleep on your stomach, as this causes additional stress on both the neck and spine. Furthermore, you may wish to use small pillows placed beneath your rib cage or shoulders to support the spine while you sleep on your side. Some patients also achieve successful pain relief by inserting a rolled towel between their knees. Ultimately, you will have to experiment to find out what works best for you.

Many cases of scoliosis are mild and don’t require treatment beyond preventative bracing. Bracing, while not a cure, will prevent you or your child’s scoliotic curves from progressing, which could mean avoiding a costly surgical procedure. Furthermore, there are certain exercises that are great for patients with scoliotic curves. That being said, you should speak with your doctor or specialist before trying them yourself. Performing an exercise improperly may cause more harm than good.

As far as spine surgery is concerned, your doctor will likely perform some variation of spinal fusion. With spinal fusion, your surgeon will connect two or more vertebrae together using metal rods, hooks, screws, or wires. These instruments will help hold the spine in place while the old and new bone material fuses together over time. If the curves are progressing rapidly at a young age, the surgeon may install an adjustable rod that can change in length as the child grows.

Before anything, your doctor will most likely begin by gathering information. Naturally, this includes exploring the patient’s medical history and is usually supplemented by a physical exam. The physical exam is typically a forward bending test that will let the doctor know if one side of the rib cage is more prominent than the other. Additionally, your doctor may also check for muscle weakness, numbness, and abnormal reflexes. To confirm a diagnosis, your doctor may also order imaging tests, such as X-rays or even an MRI.

Sure. Here’s a short list:

• Avoid texting. We bend forward when we text. This applies pressure on the spinal cord.
• Avoid swimming. This places undue stress on the thoracic spine and can drive curve progression.
• Don’t play high-contact sports. Sports such as football can severely trigger an underlying case of idiopathic scoliosis.
• No torso extensions. Gymnastics, high jumps, and certain dance maneuvers can further rotate the vertebrae into existing scoliotic curves.
• Don’t lift heavy objects. Carrying heavy things naturally compresses your spine—and it often does so asymmetrically. This is awful for patients with scoliosis.

There’s a number of things you can do:

• • Stretch. Stretching helps with painful symptoms and general discomfort all in one go. Try bending in the direction of your curve or hanging from a bar for as long as you can.
  • Work on your core strength. Exercises that improve core strength are great for patients with scoliosis.
  • Get clinically tested. There’s a good chance that patients with scoliosis also have a neurotransmitter, hormonal, or nutritional imbalance. Correcting these imbalances can have positive effects on existing spinal deformities.
  • Play low-impact sports. Sports like soccer are great for aerobic exercise for the core, which helps combat scoliotic curve progression.

The cause of any given case of scoliosis is a complicated business. Generally speaking, a slew of combined factors cause the condition—not just one, singular culprit. Studies have ruled out the idea that curves are caused by specific behaviors such as regularly carrying heavy loads or living in an industrialized area, but that doesn’t mean that these aspects don’t have any impact on scoliotic curves. We simply do not know it all… yet.

Unfortunately, the exact cost of a specific surgery is hard to determine. Costs depend on a variety of factors, such as:

• How many days you will be spending in the hospital.
• Types of material used for the surgery (adjustable rods, screws, hooks)
• The bone graft material that your surgeon uses.
• The surgeon’s fees as well as anesthesia charges
• Any complications that lead to an extended hospital stay.
• Of course, what you pay is all going to be contingent upon your insurance plan, so make sure that you discuss these things with your provider. Generally speaking, surgery is an expensive route to take.

No matter how you slice it, surgery comes with potential complications:

• Infection. Antibiotics will be given to the patient to lessen this risk.
• Bleeding. Of course, some bleeding is expected. Some patients may require a transfusion for surgery.
• Graft site pain. In some cases, patients will experience pain at the graft site after surgery.
• Nerve damage. These complications are extremely rare. Your surgeon will monitor your nerve function throughout the procedure to lessen the risk of neurological damage.
• Lung complications. These, like nerve damage, are especially rare. Healthy teenagers will rarely if ever, complain of this issue after surgery.

They can, but it’s not common. Most rods are made of titanium, cobalt-chromium, or stainless steel. Which specific implant material your surgeon uses will depend on the nature of your individual case.
If a rod breaks, that’s a pretty good sign that a portion of the spine is not fused properly. If there is not solid fusion, the rod will be repeatedly stressed as time passes. No matter how strong your rod is, repetitive stress like this will lead to eventual breaks. To avoid this issue, always carefully vet your surgeon before undergoing any procedures.