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May 2010: Diagnosing and Treating Scoliosis

01 May 2010

Dr. Purnendu Gupta, Associate Professor of Surgery, is the director of the University of Chicago Spine Center at Weiss. He is a board certified, fellowship-trained orthopaedic spine surgeon. Dr. Gupta specializes in the care of patients with scoliosis, spinal degenerative disorders, tumors, traumatic injuries and other spinal deformities.

Dr. Purnendu Gupta
Director, University of Chicago Spine Center at Weiss
Weiss Memorial Hospital
(773) 564-SPINE (7746)

What is scoliosis?
Scoliosis is an abnormal curvature of the spine. Instead of a straight vertical line from the neck to the buttocks, the spine has a C- or S-shape. Scoliosis can affect both children and adults and can develop at any time—from infant through the senior years. Many people do not realize that scoliosis can develop at any time in your life.

What causes scoliosis?
In children, scoliosis is the result of hereditary factors and can present at any age, from infanthood through puberty. Adolescent growth spurts may trigger the development or progression of scoliosis in children.

In adults, scoliosis can present itself as a slow progression of asymmetric disc degeneration leading to the development of curvature throughout later life. This type of spinal disc degeneration can be related to hereditary factors; others in your family may suffer the same disc problems.

A number of health and behavioral factors can affect scoliosis as you age. These factors include body weight, lifestyle (what you like to do and your occupation) and other medical conditions and behaviors that impact your health, such as diabetes and smoking.

Adolescents with scoliosis may experience progression of their curve due to disc degeneration each year as they age. At certain times this progression may be more rapid, for example, during the peri-menopausal years for women or as adults get older and lose bone density, like with osteoporosis.

Asymmetric disc degeneration (break down of the discs in the spine) causes unequal alignment of the discs along the spine which leads to a tilt and curvature of the spine found in scoliosis as adults age.

Symptoms and signs of scoliosis
While scoliosis can be present at birth, children and adolescents are most at risk for developing scoliosis while they are growing rapidly or reaching puberty. Teens may notice that their clothes do not fit right or that their bodies appear asymmetrical in their chest, back or trunk.
Adults may notice that they are losing height or that they appear asymmetrical in the chest and/or back, or that their clothes do not fit right anymore. Adults with degenerative scoliosis typically begin to experience back and leg pain in their 50s, which worsens in their 60s and 70s. This pain may make walking difficult. Asymmetric forces on the spine and joints cause pain and immobility as we age.

Diagnosing scoliosis
One of the oldest methods for detecting scoliosis is also still one of the best: the Adams Forward Bend Test. With this test, your physician can see and feel if you or your child’s spine is straight.

X-rays are another tool to diagnose scoliosis. Both frontal and side view X-rays capture the entire length of the spine while the patient is in a standing position.

In addition to the Bend test and X-rays, your doctor will also give you a neurological exam to observe if your arms and legs function normally, your reflexes are intact and if you have any difficulty walking.

Non-surgical treatment options for scoliosis
While there is no way to prevent or cure scoliosis, there are steps you can take to treat and minimize the severity of this condition.

Adolescents may be fitted with a brace to prevent further curvature of the spine while they are still growing. Once young adults have stopped growing, the need for more treatment will depend on the size of the curve and how it affects appearance and function. Braces are not typically used beyond the ages of 15-16 for girls and 17-18 for boys since they are generally done with growth.

Particularly for adults, strengthening your muscles through aerobic activity and strength-building exercises can dramatically help relieve pain and even slow down or prevent further curvature of the spine. Outpatient physical therapy goes a long way toward strengthening core/trunk muscles. Such strengthening exercises should be continued at home well after physical therapy ends as a lifestyle change.

Management of the pain that affects people with scoliosis is also a key element to treating this condition. We strive to effectively alleviate our patients’ acute and chronic pain through the latest pain medications and procedures.

Your doctor will also monitor any bone loss you may be experiencing in order to prevent or treat osteoporosis.

Surgical treatment options for scoliosis
The goal of surgery in the treatment of scoliosis is to help improve quality of life by treating the limiting factor for an individual, particularly severe back pain, leg pain and difficulty walking.

Through spinal surgery, known as fusion, doctors can surgically treat scoliosis to help straighten the curvature and prevent further progression. Laminectomy is often performed at the time of fusion to treat the associated spinal stenosis (pinching of the nerves in the spinal canal) by opening up the area where the nerves are compressed to help relieve the leg pain. In some cases, minimally invasive surgery may be used to perform smaller scale spinal procedures.

For more information
If you would like more information about scoliosis or other spinal conditions and diseases, or would like an appointment, please call Dr. Gupta’s office at (773) 564-SPINE (7746). Also visit the University of Chicago Spine Center at Weiss.