Scoliosis Treatment and Surgery

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Spinal surgery will stop progression of scoliosis and correct, potentially, the deviation of the spine curvature. DISC offers minimally invasive strategies to correct deviations in the spine caused by scoliosis. To find out more or to schedule your appointment call 310-574-0400.

What is Scoliosis?

Traditionally the spine forms a straight vertical midline, maintaining the axis of the body. Scoliosis refers to a deviation in the spine, resulting in a lateral curve. Scoliosis occurs most frequently in adolescents during a period of accelerated growth. Spinal deviation may affect the thoracic, lumbar, or both (thoracolumbar) regions of the spine.

Surgical and non-surgical treatments may remedy issues that result from scoliosis. The degree and location of spinal deviation will determine the best course of action.

Dr. Hooman Melamed Explains Scoliosis Condition and Treatment Options
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What Causes Scoliosis?

The majority of scoliosis (>80%) is idiopathic, meaning that the cause is unknown. Posture, leg length, sports activities, and weight carried (ie a heavy backpack) have not been shown to be causative agents of scoliosis. Often times, scoliosis presents during the growth spurt of adolescents.

Approximately 30% of children from scoliotic parents will develop the condition. Parents with scoliosis should notify their Pediatricians so that appropriate precautions can be made.

Less frequently, scoliosis may be caused by congenital, neuromuscular, or degenerative reasons. Congenital conditions are genetic and present at birth. Neuromuscular conditions, such as muscular dystrophy or cerebral palsy, have been correlated with the development of scoliosis in certain cases. Degenerative causes of scoliosis typically stem from a traumatic incident (sometimes delayed), or may be related to the natural deterioration of the spine and osteoporosis.

Diagnosing Scoliosis

The onset of scoliosis is often noticed by uneven or protruding shoulder blades, leg height, or hip line. In more extreme conditions difficulty breathing may be experienced. An Adam's Forward Bend test is also a simple method of gross evaluation of a spine's straightness.

Pain is not a typical symptom of scoliosis. If pain and/or numbness in the back or limbs are/is experienced, contact your physician.

Definitive diagnosis of scoliosis requires an X-ray. Typically patients with lateral curvature of the spine >25 degrees will be considered for treatment. The extent of the curve will dictate the types of treatment that are appropriate.

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What Should I do?

Small spinal deviations due to scoliosis are often asymptomatic. Without pain or mobility restrictions, scoliosis may prove to be a non-essential detail of a patient's life, similar to hair color or height. If the spinal deviation is significant (usually >25 degrees of deviation) treatment may be recommended.

Braces may be recommended for younger children that will experience periods of accelerated growth. By utilizing a brace appropriately further deviation may be avoided, eliminating the need for future surgical intervention. A number of braces exist, such as a TLSO (Thoraco-Lumbo-Sacral-Orthosis) brace, a Milwaukee brace (Cervico-thoraco-lumbo-sacral orthosis), or a Charleston bending brace. The brace names simply relate their position to the back and relative flexibility. Most braces may be worn underneath clothing and are not outwardly noticeable in day-to-day activities.

Traditional non-surgical methods of alleviating spinal conditions, such as physical therapy and exercise, have not been shown to be effective at remedying scoliosis. Unfortunately, scoliosis will not heal over time. The primary non-surgical strategy to treat scoliosis is early diagnosis and subsequently limiting spinal deviation during periods of growth. Utilizing a Chiropractor or other alternative medical treatments should be consulted upon with your physician.

If spinal deviations are >50 degrees, surgical intervention may be necessary. Spinal surgery will stop progression of scoliosis and correct, potentially, the deviation of the spine curvature. DISC offers minimally invasive strategies to correct deviations in the spine caused by scoliosis. Most approaches fuse vertebrae (the bones of the spine) by forming a bony bridge between adjacent levels. In some cases, rods are used to stabilize the lateral and posterior projections of the vertebrae. This is most easily envisioned by thinking of building scaffolding around the spinal structure. By adding additional support, certain vertebral fusions are more successful.

Physicians at DISC often utilize a procedure known as XLIF, or eXtreme Lateral Interbody Fusion. This minimally invasive procedure celebrates a high level of success while minimizing recovery time and discomfort post-surgery. Another similar procedure is ALIF, or Anterior Lateral Interbody Fusion. Spinal fusion alternatives are based upon the principal that forming a bony bridge between two adjacent vertebrae will inhibit further progression of scoliosis and correct a segment of the spinal deviation.