SPINAL DEFORMITY
An abnormal curve in the spine, such as scoliosis or kyphosis, is known as a spinal deformity. It can affect the spine’s ability to do its job, leading to pain, neurological problems, and mobility challenges.
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Spinal Deformity
An improper alignment or curvature of the bony vertebral column refers to a spinal deformity. To keep the body upright and the head level, the spine consists of a stack of discs and vertebrae that seem straight from the front and curved from the side. A spinal deformity refers to conditions like scoliosis or kyphosis. It may impair the spine’s capacity to carry out its function, resulting in pain, neurological issues, and mobility issues.
There are many different conditions and factors that can cause spinal abnormalities, such as birth defects, age and degeneration, and trauma. Age-related wear and tear on the spine or body and effects from prior surgery can also contribute to adult scoliosis and kyphosis. The rest of the body will suffer from this condition by developing weak or malformed spines. Simple tasks (like walking) become challenging due to muscle tension and increased lung pumping. Not the unusual shape, but strained joints and pinched nerves cause pain. Physical therapy, injections, medication, and surgery constitute the various forms of treatment.
Important Spinal Deformity Types
Typically, the type of aberrant curvature that the spine possesses helps doctors and surgeons categorize spinal abnormalities. The most typical of these are:
Kyphosis
The thoracic spine (upper back) has an excessively pronounced backward curvature when someone has kyphosis (upper back). This ailment, often known as “Dowager’s hump” or a “hunchback,” frequently results from osteoarthritis or osteoporosis. This type of spinal malformation is more likely to develop in older persons, particularly women.
Lordosis
Lordosis, also known as “swayback,” is an exaggerated forward curvature of the lumbar spine (lower back). This condition causes the abdomen to protrude forward and the buttocks to protrude outward. Obesity, excessive kyphosis, or spondylolisthesis can all cause lordosis.
Scoliosis
Juvenile Scoliosis is a more common condition characterized by lateral curvature of the spine. The onset of scoliosis, described as an S-curve, most commonly occurs before puberty. Signs of scoliosis include uneven hips, bulging shoulder blades, uneven shoulders, and possible twisting of the spine.
Flatback
In a flatback, the lower back’s normal curvature is lessened. This results in a straight or flat lower back, which ripples the upper spine. People could seem slumped over. Or, when the spine makes up for the loss of lower back curvature, tightness may develop in the hamstrings.
QUESTIONS AND ANSWERS
What are the treatment options for my child's spinal deformity, and will surgery be necessary?
The treatment approach depends on the type and severity of the spinal deformity. Doctors manage mild cases with observation, physical therapy, and orthopedic interventions like bracing. For more severe or progressive deformities, especially in idiopathic scoliosis, doctors may recommend surgery to straighten and stabilize the spine.
The decision to conduct surgery is based on factors such as the degree of curvature, the child’s age, and the potential for further progression. The doctor will discuss the available treatment options and help determine the most appropriate plan for the child.
What caused my child's spinal deformity, and could it have been prevented?
Spinal deformities can have various causes, including congenital factors, neuromuscular conditions, or idiopathic (unknown) origins. Congenital scoliosis, for example, may appear at birth due to abnormal spinal development. Doctors associate neuromuscular scoliosis with conditions like cerebral palsy or muscular dystrophy. Idiopathic scoliosis, the most common type, often develops during adolescence without a clear cause. In many cases, spinal deformities are not preventable, but early detection and intervention can help manage the condition more effectively.
What is the long-term outlook for my child with a spinal deformity, and will it impact their daily life?
The long-term outlook varies depending on the type and severity of the spinal deformity, as well as the effectiveness of treatment. With proper management, many children with spinal deformities can lead active, fulfilling lives. Regular follow-up appointments and monitoring are essential to track the progression of the deformity and make any necessary adjustments to the treatment plan. In some cases, ongoing care may continue into adulthood. The impact on daily life will depend on the specific characteristics of the spinal deformity and how well it responds to treatment.
Parents should maintain open communication with healthcare professionals to address their specific concerns about their child’s spinal deformity. The medical team will provide detailed information about the condition, discuss treatment options, and offer guidance on managing the child’s health and well-being.
Schedule an Appointment for your child to be seen by one of the doctors at the Medical City Children’s Orthopedic and Spine Specialists for a spinal deformity
Spinal Deformity Types that are Less Frequent
Other prominent but less frequent causes of spinal malformation include:
Scheuermann’s Disease
This condition occurs in children and adolescents. Similar to kyphosis, this condition causes an exaggerated hump in the thoracic spine. However, in this disease, the cause relates to the failure of spine’s growth. This condition can cause significant pain and disability.
Postsurgical Deformity
Spinal surgery can also cause various deformities. Postoperative deformity typically occurs when spinal fusion surgery fails to fully fuse the target bones or when the spine does not heal properly after surgery. A failed surgery can result in further curvature of the spine and associated pain and stiffness at the surgical site.
Spinal Deformity Symptoms
The signs and symptoms of spinal abnormalities can differ greatly due to the wide range of factors that might result in them. The kind and degree of the spinal deformity will have a significant impact on the symptoms. Some people with the illness won’t even have any symptoms. Furthermore, unless arthritis, spinal fractures, or other inflammatory disorders cause the spinal deformity, pain may not occur as a symptom.
The Spine May Change Visibly Due to a Mild to Severe Deformity
Due to the fact that doctors can identify a spinal deformity solely through visual examination, doctors start with a physical examination. Because the condition can easily be seen, the doctor can make a very quick diagnosis. But the individual with the deformity may also feel alienated through this prominence. An extremely difficult component of the illness for teens or young adults who may have a spinal deformity is the psychological impact of such a condition.
Identifying a Spinal Deformity
A doctor will conduct a physical examination and request spine X-rays to determine the existence of a spinal abnormality. The patient will often shift into a few postures during an examination, such as a forward bend, so the doctor can see the spine as it moves. The doctor may suggest imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, to examine the internal anatomy of the spine and surrounding region in order to determine if an underlying reason exists for the curvature.
Spinal Deformity Complications
Kyphosis can result in back discomfort as well as:
Limited physical functions
Kyphosis refers to weakness of the back muscles and difficulty with tasks such as walking or getting up from a chair. A crooked spine can make it difficult to look up or drive, and can even cause pain when lying down.
Digestive problems
Severe kyphosis can compress the digestive tract and cause problems such as heartburn and difficulty swallowing.
Spinal Deformity Body Image Problems
Kyphosis patients, particularly teenagers, may struggle with body image issues as a result of their rounded backs.
Causes
A healthy spine consists of bones called vertebrae, which resemble cylindrical columns when placed one over the other. Back vertebrae develop a more wedge-like form, which refers to kyphosis. Vertebrae can alter in shape due to:
Fractures
When vertebrae are fractured, the spine may curve. Compression fractures, which can occur when a bone is weak, are the most common kind of fractures. Mild compression fractures typically lack any noticeable symptoms or warning signs.
Osteoporosis
Spinal curvature can result from weak bones, particularly if fragile vertebrae have compression fractures. Osteoporosis is more likely to occur in older women and those who have taken corticosteroids for an extended period of time.
Disk degeneration
Soft, spherical discs serve as spacers between the spinal vertebrae. As we become older, these discs flatten and shrink, which typically exacerbates kyphosis.
Scheuermann’s disease
This condition, which is also known as Scheuermann’s kyphosis, often starts during the growth spurt before puberty.
Other problems
The spine’s bones not forming properly before birth might lead to kyphosis. Kyphosis in children can coexist with other medical conditions like Ehlers-Danlos syndrome.
Spinal Deformity Treatment Options
The degree of the spine’s curvature, how it affects the patient’s daily functioning, their age, and other medical issues are all taken into consideration when recommending a course of treatment. Cosmetic appearance is a justification for surgery in a relatively small percentage of younger patients. The therapy should, in general, meet the severity of the symptoms in order to stop, slow down or reverse the condition.
Bracing of Spinal Deformity
Bracing is the first option for younger individuals with milder types of spinal abnormalities. The brace is used to straighten the spine and prevent further progression. A brace may provide some pain relief for children who are still growing.
Physical Therapy
The flexibility and strengthening of the spine’s core are a cornerstone of treatment, and physiotherapy can help with these aspects (PT). There are several appropriate types of physical therapy, but they all include the patient engaging in activity to strengthen the spinal musculature, increase the range of motion, and enhance balance. It should involve active steps rather than only passive ones like massage, heat, or ice.
Surgical Treatment
The usual patient should have attempted non-operative management of their symptoms before considering surgery. Patients with medically untreatable pain or neurologic problems including numbness, weakness, or bowel or bladder dysfunction should think about having surgery. Surgery is frequently required due to the curvature progressively getting worse, which is why patients are monitored with yearly X-rays. In spite of all non-operative therapy attempts, severe curves seem to always get worse; like a tree falling down, once it starts, it’s impossible to stop without intervention.
Spinal Fusion Surgery
Most commonly used in conditions such as scoliosis and kyphosis, physicians use rods, plates, and screws to mechanically connect one or more vertebrae to straighten collapsed spinal structures. This process straightens the curves associated with scoliosis.
Decompression Procedures for a Spinal Deformity
Making room in a compressed spine due to spinal deformity is a task of decompression surgery. Your doctor will remove any structures that are compressing the spine during this treatment using a number of techniques, such as laminectomy or foraminotomy.
Osteotomy
The act of removing bone structures is known as an osteotomy. For the purpose of adjusting the angle at which bones lie together, this may include the removal of a vertebra entirely or simply a portion of it. Treatment for flatback or scoliosis frequently involves this operation.
For providing cutting-edge pediatric orthopedic care, The Medical City Children’s Orthopedics and Spine Specialists has received recognition. Families go from all over the world to consult with our skeletal dysplasia specialists. Even the most uncommon skeletal dysplasia, such as a Spinal deformity, may be diagnosed through our genetics specialists thanks to their expertise and education (SED). After determining your child’s health, our care teams collaborate to develop a specialized treatment strategy that is tailored to your family’s requirements.
Our recognized pediatric orthopedic specialists are responsible for the treatment. Skeletal dysplasia may vary and evolve over time; thus, the Medical City Children’s Orthopedics and Spine Specialists has developed one of the best pediatric imaging systems in the world to monitor and record changes in children’s bodies. We invite moms and dads to bring their children to us when their children have spinal conditions that warrant the very best in medical treatment. We have offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.
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Footnote:
National Institute of Health: Spinal Deformity
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