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Scoliosis: Signs, Symptoms and Treatment

Scoliosis is a medical condition that causes an abnormal curvature of the backbone. A person’s spine is curved from sideways in this disorder. This is a complex three-dimensional disfigurement, on an x-ray observed from the rear, the spine of a patient with scoliosis may appear as S or C shaped figure than a straight line. Scoliosis is commonly classified as either congenital, due to vertebral irregularities present at birth of an individual, idiopathic cause is unknown, sub-classified as juvenile or adult, or neuromuscular when developed as a peripheral symptom of another condition, such as cerebral palsy, or physical trauma. Scoliosis surgery is one of the most complicated orthopedic procedures performed on patients to correct the condition of scoliosis. Scoliosis is best treated when found early and can also be easily detected during routine screening.

 

Various Types of Scoliosis

Scoliosis Types

There are various types of scoliosis. They are defined and named according to the age factor, cause and spinal curvature. Basic types of scoliosis include the following.

  1. Structural Scoliosis: It is caused by neuromuscular deformities, birth defects, connective tissue disorders, injury, rheumatic diseases, or tumors.
  2. Nonstructural Scoliosis (functional): This condition of scoliosis is reasoned by existing conditions such as a difference in length of legs, muscle spasms, and conditions including appendicitis (inflammatory conditions).
  3. Idiopathic Scoliosis: It is the most common type of scoliosis based upon the age factor. It affects about 3 to 4% of the total population, generally females. Reason behind this disorder may include hereditary conditions, infections, injury and tumors. This falls under the following three sub-groups.
  • Infantile Scoliosis: It continues from birth to age three.
  • Juvenile Scoliosis: It develops between the ages three to nine years.
  • Adolescent Scoliosis: This scoliosis extends from age of 10 to 18 years.

 

Some Other Types of Scoliosis

  • Congenital Scoliosis: It is a rare type of scoliosis caused by unconventionally shaped bone that is present in the patient since birth.
  • Neuromuscular Scoliosis: It is a lateral curvature of spine occurring due to weakness in muscles or neuromuscular diseases such as paralytic conditions, cerebral palsy, spina bifida, spinal cord tumors, muscular dystrophy, and neurofibromatosis.
  • Degenerative Scoliosis: This generally occurs in older people due to weakening of spine with aging. Weakening of soft tissues & ligaments of the spine combined with irregular bone spurs can lead to deformity of spine.

Scoliosis can also be categorized on the basis of the spinal curvature.

  • Thoracic Curve Scoliosis
  • Thoracolumbar Curve Scoliosis
  • Lumbar Curve Scoliosis

 

What are the Causes of Scoliosis?

Scoliosis Causes

Best possible causes of scoliosis are enumerated below.

  • Genes – At least one gene is thought to be involved in scoliosis.
  • Length of Leg – if one leg is longer than the other, a person may develop scoliosis disorder.
  • Bad Posture – The curve may worsen due to bad body posture.
  • Carrying Heavy Backpacks- This may also be responsible for curvature to extend further.
  • Injuries – Some back injuries may lead to this condition.

 

What are the Signs & Symptoms of Scoliosis?

There are no exact symptoms of scoliosis, but the following symptoms are only those associated with the curved spine.

  • One hip or shoulder is more prominent than the other
  • Patient’s head may be off center
  • Asymmetrical ribcage, the ribs may be at distinct heights
  • Individuals may lean onto one side, opposite sides of the body may not appear leveled
  • One may experience back pain

What are the Treatments for Scoliosis?

Most of the children with scoliosis have mild curves and usually, they don’t need any kind of treatment. In such cases, doctor will suggest regular follow-ups every 4 to 5 months to monitor curvature of the spine in hospital and periodically with X-rays. A person’s gender, curve position and severity of curvature are essential factors when deciding on treatment. The following treatments are available for scoliosis.

Casting

Casting is commonly used for infantile scoliosis to aid infant’s spine to return to its normal position. This can be achieved with a cast of plaster of Paris. The cast is attached to outer area of patient’s body. The cast is changed regularly because infants grow briskly.

Braces

If a patient has moderate scoliosis and his bones are in a growing stage, surgeons may recommend a brace to prevent further curvature formation. Braces are usually worn all the time, even at night.

There are basically two types of braces:

  1. TLSO (Thoracolumbosacral Orthosis) – TLSO is composed of plastic and designed to fit neatly around the curves of the patient’s body.
  2. Milwaukee Brace – It is a full-torso brace and has a neck ring with rests for the chin at the back of the head. These braces are used only when TLSO is not effective.

Surgery for Scoliosis

Scoliosis can progress over time and may become severe. In such cases, doctors may suggest spinal fusion surgery. This surgery minimizes curvature of spine and restricts it from getting worse. Two or more spine bones are fused with new bone grafts. Sometimes, screws, hooks, metal rods or wires are used to hold the spine neat & straight while the bone heals. This surgical procedure lasts from 7 to 8 hours of time. After completion of surgery, the child is transferred to an intensive care unit where they will be given pain relief and intravenous fluids. Children can normally return to school after 5 to 6 weeks, and can play sports roughly one year after surgery. A back brace is needed to support the spine in some cases for about four to six months. The patient will need to return to clinic every 6 months to have these rods lengthened – this is an outpatient method, so the patient does not have to spend the night at hospital.  Doctors surgically remove these rods once the spine has grown.

 

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