Scoliosis is an abnormal curvature of the spine. This term is used to characterize a sideways and unnatural curving of the spine. A spine affected by scoliosis may resemble the letter “C” or “S.” Scoliosis typically starts to develop during the growth spurt that many children experience just prior to the onset of puberty. There are several kinds of scoliosis. Functional scoliosis is caused by an abnormality elsewhere in the body, such as when one leg is shorter than the other. Structural scoliosis is linked to other diseases, syndromes, or birth defects.
Surgery is often the best way to resolve scoliosis when the abnormal curve of the spine is greater than 45 to 50 degrees. Often, when the spine is curved to this degree, the abnormal curvature will continue, and surgery is the most effective way to straighten the spine and prevent additional deformity. In addition to the deformity and pain associated with scoliosis, the condition can also compress the lungs and prevent full lung function.
Your treatment depends on three factors, your age, the severity of the curve, and the amount of disability the deformity causes you. Pain is usually a factor in adult cases usually over the age of 35. While children only have pain in relationship to infections, spinal tumors, or herniated discs. Cosmesis is also an issue in some cases.
If you are still growing you may be fitted for a TLSO or spinal brace. If your curve is less than 40 degrees, a brace may stop the progression of the curve. A brace cannot correct the curve. You will have to wear the brace until your spine stops growing. It is uncomfortable, but it may prevent the need for surgery.
If your curve is over 45 degrees you still need surgery by inserting a rod into the spine and fusing the spine. This will prevent progression of the curve. Correction of your deformity may be possible especially if you are young and your spine is not stiff or brittle. If you are over 40, some correction of the curve is possible, but complete correction is very difficult.
If you are an adult, wearing a brace will support the spine especially if your muscles are weak, but it will not correct the curve. It may also improve symptoms of pain if this is a problem, but the brace is very expensive and uncomfortable and most patients would prefer surgery to this kind of treatment.
If you are an adolescent, and your curve is 45 degrees or more, you will probably require surgery. The surgery can correct your deformity and prevent it from getting worse. There are various approaches to this surgery and you will want to have a complete evaluation and discussion of the various options with the surgeon.
If you are an adult such surgery should be approached with caution. Only the major deforming curve should be fixed. The smaller the fusion, the better the spinal function. The indications for surgery should be progression of the curve with x-rays taken over a several year period, severe pain caused by nerve entrapment which usually occurs in the concavity of curve, and rarely respiratory failure which can occur in very severe conditions that cause deformity of the chest wall.
Cosmetic problems can be considered, but remember it is very difficult to make this condition perfect in an adult. If you do not have severe pain, think twice about having the surgery.
Spinal fusion is the most common surgical procedure used to correct scoliosis. During spinal fusion, the curved and malformed vertebrae are joined together, healing into a single solid bone. Spinal fusion is typically performed with a bone graft to promote the fusion. Often, metal rods are placed along the spine to hold it in the correct position while the spine heals and the bones fuse together. Once the vertebrae are fused, the abnormal growth is stopped, and the curvature of the spine is prevented. Following surgery and recovery, patients will be able to participate in normal daily activities and sports. The fused parts of the spine will be immobile, but the rest of the spine will move as normal. Recovery and post-operative physical therapy will help to restore full mobility and flexibility to the unfused parts of the spine. Dr. Light will provide a comprehensive consultation before performing any surgery to ensure that the best treatment possible is provided to the patient.
We accept assignment on all Medicare patients, participating provider organizations (PPO), and Workers' Compensation. However, some insurance companies do cover the doctors' services as an out of network provider.
As a courtesy, we will bill your insurance company for you if you have provided us with the insurance name, policy numbers, address, place of employment and any other pertinent information. You are responsible for all deductibles, co-pays, and charges not covered by your insurance. Failure to submit payment for your portion of your bill may result in referring your account to a collection agency. All co-payments will be collected at the time of service.
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