Pediatric Orthopedic Surgeons treating a Spinal Deformity

SPINAL DEFORMITY

 

An abnormal curve in your spine, such as scoliosis or kyphosis, is known as a spinal deformity. It can affect your 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 is referred to as a spinal deformity. To keep the body upright and the head level, the spine is made up of an exquisite stack of discs and vertebrae that seem straight from the front and curved from the side. A spinal deformity is an unnatural curve in your spine, such as scoliosis or kyphosis. It may impair your 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 be affected by 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 are among the 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

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.

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, the disease is not caused by degeneration, but by the failure of the growth of the spine. 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

Your illness might be asymptomatic:

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 that is present 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 are the root cause of the spinal deformity, pain is not typically a primary 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.  The condition is visible to others, which can help with a quicker 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 scoliosis is the psychological impact of a spinal deformity.

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 be asked to shift into a few postures during an examination, such as a forward bend, so the doctor can see the spine as it moves. We 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 whether there is an underlying reason for the curvature.

Spinal Deformity Complications

Kyphosis can result in back discomfort as well as:

Limited physical functions

Kyphosis is associated with 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 is made up of bones called vertebrae, which resemble cylindrical columns when placed one over the other. Back vertebrae develop a more wedge-like form, which is 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, be commensurate with the severity and hazards of the symptoms.

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 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 and failed 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 are thought to be unstable and have a tendency to 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 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 they have children conditions that warrant the very best in medical treatment.

Call 214-556-0590 to make an appointment.

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