Innovative Treatments for Spinal Scoliosis
Innovative Treatments for Spinal Scoliosis
Think you might have spinal scoliosis?
Believe it or not, many people who suffer from this condition don’t even know that they have it! Meanwhile, others have such severe cases that it drastically impacts how they approach their daily lives. These people may require surgery, while others can coast by without intervention or with conservative treatments alone.
Thankfully, modern medicine has come a long way in the past 100 years. In fact, the earliest milestones in minimally invasive spine surgery date all the way back to 1941. Needless to say, the last 80 years have brought sweeping improvements in scoliosis treatment.
We’re incredibly lucky to live in an age where we don’t need to perform exploratory surgery to diagnose issues with the spine. These days, sophisticated imaging tools allow us to diagnose orthopedic problems without ever having to pick up the scalpel. And, even when we must resort to surgery, endoscopic camera guidance enables doctors to use the smallest incisions possible. Naturally, smaller incisions also mean quicker recovery times, less blood loss, and fewer opportunities for complications to occur during the surgical process.
But, of course, you still require the highest standard in medical care when you have these procedures performed. Needless to say, you’re going to want someone qualified, who has earned board certification, fellowship-training, and the respect of his or her industry—someone like Dr. Jason E. Lowenstein.
What is Spinal Scoliosis?
Spinal scoliosis refers to an abnormal sideways curvature in the spine. Most commonly, this condition emerges during the growth spurts that occur directly before puberty. This isn’t to say that spinal scoliosis can’t occur in adults or even younger children. However, the bulk of scoliosis patients are typically adolescents.
Thankfully, most cases of spinal scoliosis are mild, but sometimes surgical correction is necessary if the scoliotic curves are severe enough. If you think that you or your child has scoliosis, you should keep an eye out for the following symptoms:
- Asymmetry in the shoulder blades
- Asymmetry in the hips and waist
- A rotating spine
- Breathing problems (only in the most severe cases)
- Back pain
- Difficulty walking
- Reduced range of motion
- Cardiovascular problems created by compression of the torso
- Negative body image (psychological)
- …and more.
Keep in mind, this is only a general list of the most common scoliosis symptoms. In fact, we’ve included some of the most severe symptoms of spinal scoliosis at the end of the list.
Most people will experience varying degrees of the first few symptoms. But, as the condition progresses, patients may find that they experience cardiovascular problems or breathing issues as well. If you have any of the symptoms in the latter half of this list, it is imperative that you seek medical attention as soon as possible. A more dangerous underlying condition could also result in these symptoms. For more information, contact your general physician or spine specialist at your earliest convenience.
Diagnosing Spinal Scoliosis
Generally speaking, there are two main types of scoliosis: congenital and idiopathic. Congenital scoliosis refers to cases in which the condition is present at birth. In contrast, idiopathic scoliosis describes a scenario in which the underlying cause of scoliosis cannot be determined. In the vast majority of spinal scoliosis cases, patients typically have idiopathic scoliosis.
While an official diagnosis of spinal scoliosis requires X-ray confirmation, there are a few physical examinations that your doctor may want to perform as well:
- Adam’s Forward Bend Test: Primarily, this test looks for abnormal spine rotation. During this test, your healthcare professional observes the patient bending forward at a 90-degree angle with his or her arms outstretched toward the floor while locking his or her knees. In this position, scoliotic curves become readily apparent. Your doctor will be able to discern any bodily asymmetries in the shoulders, rib cage, hips, and waist.
- Scoliometer: Your doctor may utilize this instrument in conjunction with the Adam’s Forward Bend Test. A scoliometer, or inclinometer, estimates the angle of trunk rotation while the patient is bending forward. Generally speaking, if the scoliometer picks up an angle of trunk rotation greater than 5 degrees, follow-up with the patient is required (via X-ray imaging).
- Cobb Angle Measurement: A Cobb angle is determined while observing the results of an X-ray imaging test. While looking at an X-ray image of the spine, the practicing doctor may determine the Cobb angle by drawing a perpendicular line from the spine’s most tilted vertebrae above the scoliotic curve’s apex. A second perpendicular line is then drawn from the most tilted curve beneath the apex. Where these two lines intersect is what doctors refer to as the Cobb angle. For a scoliosis diagnosis, a Cobb angle of 10 degrees or greater designates scoliosis.
What Are The Treatment Options For Spinal Scoliosis?
Generally speaking, treatment can be broken up into three different subcategories: conservative, minimally invasive, and traditional or open-back surgery.
While not necessarily a cure for spinal scoliosis, bracing may prevent scoliotic curves from progressing. In many cases, this means that the patient may be able to avoid surgical correction if he or she wears a brace at regular intervals. Scoliosis bracing may be required full-time (exceptions being made for bathing, skincare, and exercising) or performed on a nighttime schedule.
There are also certain exercises that one can perform daily in order to help alleviate negative symptoms. For more information on which exercises to perform, you should talk with your scoliosis specialist. You want to make sure that you’re exercising correctly, otherwise, you could actually worsen your condition.
And, of course, for pain, patients always have the option of using over-the-counter medication such as Ibuprofen and Tylenol. Your mileage with these drugs may vary, however. If these options are not effective for you, you may wish to consider something a little bit stronger such as steroid injections.
Minimally Invasive Surgical Procedures For Spinal Scoliosis
When it comes to spinal scoliosis surgery, there are generally three goals in mind:
- Diminish the deformity: Of course, this depends on how much flexibility is still within the spine. With this in mind, spinal scoliosis surgery seeks to de-rotate the abnormal twisting in the spine while simultaneously adding stability back to the spine.
- Maintain trunk balance: When a change is made to the spine’s position, your surgeon must ensure overall trunk stability, keeping the hips and legs as symmetrical as possible.
- Halt the progression of scoliotic curves: Cases that require scoliosis surgery would often progress into more serious forms of the deformity without crucial intervention.
Generally speaking, there are three major options for scoliosis surgery:
- Spinal Fusion: Your doctor will fuse two or more adjacent vertebrae together in order to increase stability in the spine. The performing surgeon may utilize rods, screws, hooks, and/or wires to accomplish this.
- Scoliosis Growing Rods: In scoliosis growing systems, your doctor will place adjustable rods in the spine that he/she can modify as the patient grows. Of course, this requires additional surgery to make these adjustments, and usually, the patient requires spinal fusion in the future.
- Fusionless Systems: This is one of the newest innovations in spinal scoliosis treatment. Also known as Vertebral Body Tethering (VBT), your doctor employs a growth modulator that applies constant pressure on the convex side of the problematic curve, forcing it to grow more densely and slowly. Meanwhile, the concave side of the spine is allowed to grow at a normal rate, thus pulling the spine back into healthy alignment.
Have you been experiencing debilitating symptoms that have lasted for a period of two weeks or more? Have more conservative options such as physical therapy or over-the-counter medication not been enough to relieve your discomfort? If so, then it might be time to give our office a call at (855) 220-5966.
Dr. Jason Lowenstein is a founding member of The Advanced Spine Center and has been recognized locally, nationally, and internationally as an active member of the Scoliosis Research Society (one of the oldest and most prestigious international spine societies). Additionally, Dr. Lowenstein has been recognized for his stellar work, earning numerous Top Doctor awards from Castle Connoly, Inside Jersey Magazine, New Jersey Monthly Magazine, and more.
For more information, contact our offices as soon as possible. You deserve a pain-free life!