Saturday, March 28, 2015

Is it a Pose? Or Scoliosis?

Sometimes we can observe other people with one shoulder higher than the other.  Makes me wonder if it's just a pose or something pathologic (abnormal condition).   If the person is just standing, then maybe, it's a pose to accentuate her dress.  However, if she starts walking and the other shoulder is still higher than the other, then there must be something wrong.

The condition is called Scoliosis when the spine or backbone bends or curves to the side.  The spine has a normal forward and backward curvature, but never a sideward curve.  In Scoliosis, the spine curves to the right or to the left (C curve) or it can have two curves (S curve).  This disease can manifest at any age but commonly appears at 10 years and older.  The condition maybe mild, moderate or severe and this classification dictates which form of treatment to give.

Please pardon me for making the female species as an example for this disease but statistics show that females tend to develop worse symptoms.  Other signs to diagnose this illness are:  uneven leg lengths, one hip is more prominent than the other or the person may always lean on one side.  The change in curvature occurs very slowly, that's why it is unnoticed until it becomes severe.  Pain is also part of the symptoms but is not very common.  If the patient complains of pain, then other causes of pain should be investigated.  In severe cases, the heart and the lungs do not function properly because of the abnormal structure and these will be manifested as shortness of breath and/or occasional chest pains.

What is the cause of this illness?  In 80% of cases, the cause is unknown.   The other 20% is the result of hereditary factors (runs in the family), neuromuscular conditions, birth defects affecting development of bones and injuries or infections of the spine.

Physical examination can clinch the diagnosis with supporting laboratories like Xray, CT scan and MRI.

Majority of the cases, less than 25 degrees deviation, need no treatment but repeated clinic visits are required to monitor the progression of the disease.  Moderate cases with 25 - 40 degrees deviation from main spine axis need to have braces as treatment.  Braces prevent further curvature but cannot correct the existing curve.  Braces will reduce the need for surgery later in life.  Surgery, which is spinal fusion, is indicated for severe angulation greater than 40 degrees.  Metallic implants are put in place to hold the spine in a straight position.  Post surgery patients can engage in sports one year after the procedure.  The operation is not without risks, therefore make sure that the surgeon has vast experience with this disease before undergoing surgery.

Scoliotic patients with back pain may benefit from exercise, massage, physical therapy and yoga.

Aside from feeling insecure due to inappropriate posture, untreated scoliosis can result to kyphosis (hunchback), lung and heart problems, chronic back pain and spine arthritis.  Checking yourself regularly in front of the mirror is not totally narcissistic (wink), you can actually diagnose if you have Scoliosis.

Dr. A


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