Scoliosis & Other Spinal Curvatures

Scoliosis & Other Spinal Curvatures


Scoliosis - Types, Causes & Treatment in India

Scoliosis is a neuromuscular disorder caused due to several medical conditions of the spinal curvature. The spine of a normal person has a curve near the shoulders and at the lower back. However, in the case of scoliosis on the outside, it may look like a bone condition. The spine's three-dimensional alignment which causes a curve is one of the major symptoms of the Scoliosis. Scoliosis most commonly occurs in children of the age group 10-15 but also occurs in adults as well as infants. Scoliosis may describe a spinal curve of 15 degrees or more than 50 degrees. The curve can occur at the different points of the spine, which may or major bend the pelvis. Scoliosis is a progressive disorder. Therefore, it is essential to get scoliosis treatment as soon as the condition is diagnosed.

As per the American Association of Neurological Surgeons (AANS), 80% of scoliosis of the spine is non-identifiable. It is diagnosed over the first seven years of the child's life. Common causes can be:

  • genetic conditions
  • birth defects
  • neurological abnormalities

Types of Scoliosis

There can be many types of scoliosis which are categorized according to the age when it starts to progress along with its cause. The main types of Scoliosis are:

Idiopathic Scoliosis

There can be many types of scoliosis which are categorized according to the age when it starts to progress along with its cause. The largest category of types of scoliosis is idiopathic scoliosis - a term used to refer to cases with no definite cause. Scoliosis whose causes are not identified terms as “idiopathic” by the doctor. It can be sub-divided into:

  • Scoliosis in Infants: 0 to 3 years
  • Scoliosis in Juveniles: 4 to 10 years
  • Scoliosis in Adolescents: 11 to 18 years
  • Scoliosis in Adults: 18+ years

Scoliosis in Adolescents is the most common amongst the types of scoliosis, according to AANS. 

Congenital Scoliosis

This is a rare type of scoliosis, which is present at the birth and is caused due to partial development of vertebrae prior to birth. It occurs in only 1 in 10,000 newborns and is less common as compared to the type of scoliosis that begins in adolescents. Even if an infant is born with scoliosis, it is sometimes impossible to detect it until the child reaches adolescence.

Types of Congenital Scoliosis:

  • Incomplete Formation of Vertebrae
  • Failure of Separation of Vertebrae
  • Combination of Bars and Hemivertebrae
  • Compensatory Curves

Neuromuscular or Myopathic Scoliosis

Neuromuscular scoliosis in children is caused due to the diseases that affect the neurologic and muscular systems in the body. For eg., cerebral palsy, muscular dystrophy, metabolic diseases, and connective tissue disorders such as Marfan's syndrome trigger scoliosis in children. It happens when there is damage to the brain or nerves caused by illness or injury. They can affect the muscle-nerve pathways of the body from the brain down to the spinal cord. Patients with these conditions often develop scoliosis or kyphosis, or both.

Difference between Scoliosis and Kyphosis:

Kyphosis: The excessive curvature of the spine in the sagittal (A-P) plane is referred to as Kyphosis. The condition is sometimes known as 'round back' in severe cases as 'hunchback'.

Scoliosis: The curvature of the spine in the coronal (lateral) plane is referred to as scoliosis.

Degenerative Scoliosis

Adult scoliosis which is caused due to degenerative changes in the spine and typically occurs after age 65. The degeneration of facet joints intervertebral discs can result in asymmetry of the spine over a period of time, as the person ages.

Recommended doctors for Scoliosis Treatment in India

CureIndia helps you choose the right doctor for your medical treatment. Most of the doctors in our associated hospitals have been internationally trained and are active members of many international medical councils and associations.
Let's hear from some of the most reputed doctor's for scoliosis treatment in India.

1. Dr Manoj Miglani

2. Dr Hitesh Garg

2. Dr(prof) Ramandeep Singh Dang

Causes of Scoliosis

In most cases, doctors have been unable to identify the exact causes of scoliosis. That being mentioned, about 30% of the children with idiopathic causes have a family history of scoliosis but the exact genetic association cannot be identified. However, some scoliosis does have exact causes. Doctors have classified the curve caused due to scoliosis into two categories: Nonstructural and Structural.

  • Nonstructural (functional): This type of Scoliosis causes the spine to curve but it is a temporary condition as it can later return to its normal alignment. The curvature that is caused in Non-structural is due to the result of another medical problem. Eg. One leg is shorter than another, muscle spasms, ruptured disc, or abdominal problems.
  • In this type of Scoliosis, the curvature of the spine is not normal and can not be reversed as this type of Scoliosis is not temporary. The condition is caused as a result of abnormally shaped vertebrae or neuromuscular diseases.

Scoliosis Signs and Symptoms

The most common signs of scoliosis in children start springing up during the adolescence starting from 10 years of age. Symptoms of scoliosis include:

  • The head is slightly off centre
  • An unsymmetrical ribcage, where the ribs may be at different levels
  • One hip is more prominent than the other
  • Clothes do not hang properly off the body
  • One shoulder, (or shoulder blade) is higher than the other
  • Back pain but not very severe 
  • Uneven lengths of both legs 
  • Uneven waist area 

In infants, the symptoms of Scoliosis may include:

  • A bulge on one side of the chest
  • The baby might consistently lie curved to one side
  • In more severe cases, problems with the heart and lungs, leading to shortness of breath and chest pain

Factors affecting Scoliosis Treatment in India

There are many treatment options for scoliosis in children and scoliosis treatment in adults, which may depend on factors like 

  • Age
  • Sex
  • The severity of the curve
  • Curve Position 
  • Bone Maturity.

Three main types of Scoliosis treatment in India are:

The treatment of scoliosis depends on the severity of the condition of the individual. Severe scoliosis progresses with time, so the doctor might suggest surgery to reduce the severity of the spinal curvature.

Braces

For patients suffering from mild scoliosis, the doctor may recommend a brace. This is done to prevent the further curvature of the spine. However, this will not cure the existing scoliosis condition. As a patient, you would have to wear the brace all the time, including night. Longer the brace stays with your body, more effective the treatment is. In case of any activity, children or adults with mild scoliosis can take this brace off and play. 

Casting

Sometimes, the doctor may use casting instead of braces to treat infant scoliosis so that the infant's spine can retain its normal position while it further grows. The casting is usually made of plaster of Paris.
Because such type of casting can get worn off with time, the casting can be changed over time.

Scoliosis Surgery: Spinal Fusion

In severe cases of scoliosis, where it has progressed over time to become worse, the doctor may go for the scoliosis treatment of Spinal infusion. It is a scoliosis surgery where two or more vertebrae are conjoined with new bone grafts. To hold some part of the spine for better healing of the bone, instruments like hooks, screws, metal rods or wires may be used. After you may be shifted to ICU for a few days for better care by the medical staff and be discharged after a few days.