What Are My Treatment Options for Scoliosis?

Think back on your elementary school days. Chances are that when you were in fourth or fifth grade, you visited the nurse’s office for a scoliosis screening. Today, 6 to 9 million Americans suffer scoliosis, and about three million new cases get diagnosed each year – among kids and adults.

 In this blog, Neil Bhamb, MD, unpacks what scoliosis is and how it’s diagnosed and treated.

Scoliosis explained
Let’s jump into this discussion by first defining a healthy spine. When everything is in tip-top shape, your spine curves naturally in three places – by your neck, chest, and lower back. In patients with scoliosis, the curve is abnormal and appears like a sideways curve in the shape of the letter S or C.

 Your doctor diagnoses scoliosis through a thorough medical history and physical exam. Typically, your provider confirms a scoliosis diagnosis using an X-ray. It is scoliosis if a curvature of the spine measures 10 degrees or greater.

 The cause for the majority of scoliosis cases is unknown. About 80% of all scoliosis cases classify as having an unknown origin, also called idiopathic scoliosis. Children between the ages of 10 and 12 are the most common group affected by scoliosis, with more girls than boys suffering from more severe symptoms.

When it comes to adult scoliosis sufferers, they typically fall into three different categories – those who didn’t get treatment when they were children, those who received surgical treatment as children, and those with adult-onset scoliosis. 

Adult-onset scoliosis typically gets diagnosed in patients aged 65 and above with pain in the lower back or lumbar spine region due to degeneration of the small joints that connect each vertebra to the one below it and the one above it.

Three strategies for management and treatment
Getting a scoliosis diagnosis does not necessarily mean it’s inevitable that your condition needs treatment. Only an estimated 30% of scoliosis patients require treatment. Managing or treating scoliosis falls into three possible strategies –monitoring, bracing, and surgery.

 Monitoring

This approach typically gears toward patients still growing and with a curvature of less than 20 degrees. The overarching goal of this strategy is to ensure that the curvature doesn’t worsen. This observation strategy includes periodic exams and X-rays, as needed, about every four to six months or so through adolescence. Typically, adults get monitored less often unless symptoms are getting worse.

 Bracing
While most people diagnosed with scoliosis don’t wear a brace, your provider may recommend it for children who haven’t reached spinal maturity and whose curvature is between 25 and 40 degrees. The goal of bracing is to keep the curve from progressing.

 Bracing has come a long way from the traditional styles that start from the neck. There are various styles to choose from, which begin under the arm. Although bracing can be highly effective in stopping further curve progression in children – as much as 80%, it’s all about compliance. Patients should wear the brace for 16 to 23 hours daily until growth stops. Your doctor should also check the fit of the brace regularly.

Surgery for severe cases
Spinal surgery treats severe scoliosis cases where the curvature is more than 45 to 50 degrees or if bracing fails to keep the curve from progressing. Untreated severe cases of scoliosis can worsen to the point where they affect breathing or lung function.

 Spine fusion
Surgical options for treating scoliosis in both children and adults include spine fusion. In this procedure, Dr. Bhamb joins or fuses two or more vertebrae to stop the movement between these bones, eliminating a common source of pain. Fusion surgery can address further scoliosis progression and treat lumbar instability, spinal injuries, and spondylolisthesis.

Minimally invasive spine surgery (MISS)
As a fellowship-trained board-certified minimally invasive spine surgeon, Neil Bhamb, MD, is an expert at performing spine fusion and other surgical procedures less invasively, called minimally invasive spine surgery or MISS. This approach uses smaller incisions and a less disruptive way to reach the surgical site, reaping numerous benefits to the patient, such as quicker recovery times, less pain, and a reduced risk for surgical complications.

Endoscopic spine surgery (ESS)

Endoscopic spine surgery, or ESS, takes the minimally invasive approach to the next level with even smaller incisions and the aid of small tools and a camera or endoscope to perform spine surgery. This technique typically enhances a standard range of spine mobility post-surgery. Often, you can add a robotic-assisted variation to spine surgeries.

If you or your child are showing symptoms of scoliosis, contact the office of Neil Bhamb, MD. Call or book your appointment online today.