KOCHI: Do you know Usain Bolt, Elizabeth Taylor and Princess Eugenie of York have scoliosis? The world over, 2-3 per cent of people are suffering from the condition. June is celebrated as scoliosis awareness month and the last Saturday is observed as International Scoliosis Awareness Day.
What is scoliosis?
Scoliosis is a complex spinal deformity. In simple terms, it means there is an abnormal, sideways curvature or bend of the spine. Scoliosis Research Society defines it as a lateral curvature of the spine greater than 10 degrees. This condition commonly affects growing children. Scoliosis is also associated with rotation of the vertebral bones. As the ribs are attached to the spine, this rotation causes an abnormal projection of the ribs on one side called a rib hump.
Types and causes
The causes are manifold. Some children are born with it while others develop the condition at an early age. This is known as early onset scoliosis. But the most commonly registered trait of scoliosis is known as adolescent idiopathic scoliosis (AIS). As the name implies the reason for this kind is unknown.
Scoliosis can result due to other diseases such as those affecting the neuromuscular system including cerebral palsy, neurofibromatosis, myopathy, polio etc. Scoliosis occurring in adulthood may be associated with back pain and leg pain with or without numbness.
Misconceptions
Bad posture
Parents usually complain that the child sitting, standing or lying down in awkward postures. The truth is that it is because of the condition that the child looks to be in a bad posture and not vice versa. The bottom line is that bad posture does not cause scoliosis.
Heavy school bags
Heavy school bags cause back pain in children. However, it does not cause scoliosis.
Genetics
In rare cases, scoliosis is seen in multiple people from the same family, but there is no proven data to show that it has any genetic cause.
Timing of treatment
Very often we meet patients with complex curvature of the spine who had been denied treatment by doctors who advised them to wait until the growth of the spine is completed. This is an absolutely wrong concept.
The treatment should be started whenever it is detected by a scoliosis expert such as a spine surgeon. Scoliosis can be best treated when the bones are pliable and amenable to correction of the deformity.
Consequences
Cosmetic deformity and psychosocial impact
Many people affected with scoliosis have a significant cosmetic deformity. Frequent questions asked by friends and relatives causes a lot of psychological trauma. Some of them become introverted individuals.
Breathing problems
The bent spine pushes towards the lungs causing compression and reduced respiratory capacity. Some patients feel breathlessness while running or climbing steps. In very rare and extreme cases even cardiac function may be affected.
Back pain
As the curve progresses it can affect the intervertebral disc as well as the sciatic nerve causing back pain. Leg pain, numbness, tingling and inability to stand and walk for long are common in adult scoliosis.
Diagnoses and treatment
An expert should be consulted immediately upon detection. A standing x-ray is taken to assess the degree of the spinal curve.Minor curves that have chances of progression would be given spine brace. In children less than four years of age, scoliosis is treated by the serial casting of the spine. When bent has progressed beyond 40 to 50 degrees, surgery would be the next option.
Early surgery may be recommended in some young children who are born with abnormal spinal bones. In adults, surgical option is available depending on the severity and symptoms of the patient, this is more of a tailored approach.
Dr Krishna Kumar R is the unit head of department of spine surgery at Medical Trust Hospital. (The views expressed by the author are his own)