The spine is the trunk of the body, the central supporting column responsible for stability and mobility. Taken for granted and often abused, any negative issues affecting the spine threaten the quality of life. Although strong and robust, the spine is susceptible to injury, however, there are more spinal problems due to genetic issues than through accident damage.
One of the most common genetic problems is scoliosis. Research suggests that between 2 and 3 percent of the population suffer with some degree of this disease. The severity of scoliosis can vary immensely, from being nothing more than slightly restrictive to extremely debilitating. In more severe cases, scoliosis can be a major risk to the sufferer’s health.
The medical profession looks upon scoliosis as having 4 types. They are; congenital, neuromuscular, adolescent idiopathic scoliosis, and adult de novo scoliosis. It manifests itself in the spine as sideways curve, which can be to the left, levoscoliosis, or to the right, dextroscoliosis. Scoliosis is not fully understood, with 85% of cases not having a definitive cause. That said, most cases of childhood scoliosis can be attributed to cerebral palsy and muscular dystrophy.
Although the majority of cases are idiomatic, at the Samitivej Hospital Scoliosis Center every effort will be made to diagnose the exact cause. Being able to pinpoint the cause can help in the development of a patient’s treatment plan. It can also help in the ongoing understanding of the disorder and help in the evolution of treatments.
There are strong indicators that suggest that there are hereditary factors involved in the sufferance of scoliosis, with a tendency for the disorder to run in families. Although the disorder can become apparent at any age, most cases are diagnosed in adolescence, between the ages of 10 and 15. There is no gender leaning in the sufferance of scoliosis with both males and females being equally affected.
Scoliosis, the Causes
Scoliosis can begin in the womb and develop in an unborn child, this being congenital scoliosis. In some cases, it can be identified at birth, however, in many cases it can be year before the disorder is identified. The lack of diagnosis at birth may be attributed to minute size of a newborn’s vertebrae, making it difficult to identify damage which can cause a failure in the way the vertebrae divide.
Neuromuscular scoliosis can often be misdiagnosed as cerebral palsy or spina bifida. These, and similar conditions, can lead to muscular damage resulting in a curvature of the spine. The specialists at Samitivej’s Scoliosis Center are well aware of the slight nuances between the differing conditions and are the best placed team to accurately diagnose the condition in the very young.
As the name suggests, degenerative scoliosis is the result of spinal aging and is most commonly found in the lower spine. As a person ages, the wear and tear on the vertebrae and their discs can cause their degradation, as they do so, the scoliosis becomes apparent. Degenerative scoliosis often goes undiagnosed making it difficult to know the exact number of sufferers, but research suggests that up to 60% of people over the age of 60 may have some degree of scoliosis.
The symptoms of scoliosis vary greatly and for accurate diagnosis a detailed examination is essential. The professional team at Samitivej Hospital use tried and tested and innovative techniques in diagnosing scoliosis. This is done via a physical examination as well pertinent questioning of each patient’s lifestyle, experiences and symptoms.
Some symptoms in some patients are obvious. A pronounced curvature in the spine and, when standing, a lean to one side are the most visible manifestations. The shoulders, hips and waist may appear to be out of line. One shoulder blade or ribs on one side of the body can have a greater degree of prominence than the other.
Physical discomfort, in the form of stiffness and back pain, is common place for scoliosis sufferers. Nerves around the spine can also become pinched, resulting in numbness. Painful strains and muscle fatigue are also a common symptom. This occurs due to the uneven load bearing vertically through the body and the muscles attempting to compensate for that uneven load.
Scoliosis, Who’s at Risk?
Through research and maintaining data, the team at Samitivej’s Scoliosis Center now have picture of risk groups. Although family history does seem to play a part in developing scoliosis, it isn’t an overriding factor. Males and females have equal levels of sufferance, so it would be easy to dismiss gender as a factor, however, females have a greater tendency to ongoing deterioration than males.
Age cannot be overlooked as a significant factor in developing scoliosis. Age factors are exclusive to degenerative scoliosis in adults. The age of adolescence is also significant. Youngsters going through a period of accelerated growth prior to puberty are a group of higher risk.
Excessive spinal curvature, that which exceeds 30 degrees, would normally be treated with a cast or brace. The cast or brace is fitted closely to a young person’s the upper torso and is intended to re-train the spine and reduce the level of curvature. It will also reduce the risk of the condition degenerating further. With the exception of bathing, the brace is worn constantly until natural growth ceases.
Where the condition has caused a spinal curvature of more than 45 degrees, which is considered severe, the specialist team may recommend a surgical correction procedure. In older patients where growth has finished, and there is a curvature in excess of 50 degrees, surgical correction procedure would be the preferred option.
Although being an invasive option, successful surgical correction is a permanent fix. The procedure utilizes metal rods which realign and straighten the spine. With a success rate of up to 90% Samitivej’s Scoliosis Center has an enviable reputation. Recovery would normally be expected to take up to 9 months. Post-operative therapy to regain mobility will be gradual, swimming and walking along with a low stress exercise plan will gradually build muscle strength and a patient’s confidence.
Any spinal condition will affect the quality of life for a sufferer, and that is never more true than with scoliosis. However, with accurate diagnosis, innovative treatment programs and a team of dedicated professionals, scoliosis sufferers can look forward to an improved quality of life, free of discomfort and restricted mobility.
Samitivej Hospital’s Scoliosis Center team is unequalled. It is headed up by Prof. Emer. Charoen Chotigavanich, M.D. and Prof. Prakit Tienboon, M.D. Their support staff are all professionals in varying fields, and this union of multi-faceted medical skills had produced a world leading team.