August 08, 2006
By Jacob Amrani, MD
John C. Lincoln Deer Valley Hospital
Board Certified Orthopedic/Spinal Surgeon
Deer Valley Spine Center
A New Medical Trend
Scoliosis, the development of a curved spine, usually happens to girls around the time of the pre-teen growth spurt — roughly ages 10 to 12. But scoliosis is now being diagnosed in a growing number of older women.
In most cases, the cause is unknown, and in many cases the condition cannot be reversed. While scoliosis usually isn't physically painful for pre-teens, it can be when it develops in women over the age of 55.
There are no "quick fixes," and the condition cannot usually be reversed. But with timely surgery, pain can often be relieved and the curvature can be stabilized — prevented from becoming worse.
This makes early diagnosis and treatment extremely important. If you think you have a problem, see your family doctor immediately!
What Is Scoliosis?
A normal spine is aligned from the skull to the pelvis. The vertebrae (the back bones) and discs (the spongy, fluid-filled shock absorbers between each of the vertebrae) follow a straight line, top to bottom.
By contrast, a spine with scoliosis has developed a curve in the middle or lower section of the spine. Usually — 90 percent of the time — the cause cannot be identified. In the remaining 10 percent of cases, the cause is rarely curable (i.e. muscular dystrophy or cerebral palsy).
In some older women, scoliosis can be caused when the joints in the spine don't wear out symmetrically (degenerative osteoarthritis). This causes a misalignment of the vertebrae, and curvature of the spine.
Early Detection Is Most Important
Diagnosis before the condition is critical: At the earliest stages of scoliosis development, the curvature of the spine is smaller. This means the condition poses fewer treatment challenges and it's less painful.
Starting treatment after earliest possible diagnosis: At this time, the condition is easier to treat. Bones at age 50-65 are stronger than those of people over 70. Stronger bones usually allow better surgical outcomes.
Orthopaedic braces: I don't use them. They're expensive. They're uncomfortable. Patients rarely wear them. I can't tell you how many times I've had patients come into my office for a checkup carrying an obviously never-worn brace. Once in a while you gotta listen to your patients!
Spinal fusion surgery: Imagine that the spine is a chain of links. Spinal fusion surgery is like welding the links together, so they cannot curve more than they are at the time of surgery. Fusion prevents scoliosis from becoming worse.
Sometimes in surgery the curve can be partially corrected, but usually surgery is done so that the spine is balanced — the patient's head is centered directly above his or her hips. This relieves pain and makes walking easier, even if a Z-shaped curve remains in the middle of the spine.
If you suspect your spine is curving:
- See your primary care physician as soon as possible to get your condition evaluated.
- If appropriate, get a referral to a board-certified orthopedic spine surgeon. (Not all orthopedic surgeons perform spine surgery.)
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