According to the World Health Organization, 3 out of every 100 people suffer from some type of scoliosis. Here, the experts at Instituto Clavel explain what idiopathic scoliosis is and how it is treated.
Idiopathic scoliosis is the most common kind. “Idiopathic” is the medical term used when the origin of a disease or condition is unknown. Scoliosis is an abnormal curvature of the spine, either in the shape of an "S" or "C". In many cases, the degree of curvature is minimal and does not cause any health problems. However, there are other cases where the curvature is so great that it can cause lung damage and deterioration of the joints.
Who can be affected by idiopathic scoliosis?
Girls are more predisposed to developing this type of scoliosis of the spine and the disease can appear between 10 and 14 years of age. When it is very noticeable, the body usually leans to one side and one hip looks higher than the other. In adolescents, this curvature usually does not cause pain, but in adulthood, it can cause chronic back pain and muscle contractions.
Adult scoliosis occurs more often in people over the age of 60, who probably had pre-existing adolescent idiopathic scoliosis, or in some people, it simply happens as the result of the wear and tear over time on the discs and spine. And this is common, since a significant number of people with idiopathic scoliosis have no symptoms during most of their lives.
In this group of people, the condition is usually already at a very advanced stage when they begin to have symptoms such as pain due to the curvature, or compression of the nerves, causing sciatica.
In the case of adults, this means we can distinguish between two types of scoliosis patients: adults with pre-existing idiopathic scoliosis and adults with new-onset scoliosis.
If we focus on the former, although the cause of their scoliosis is unknown, we can say that the curvature appeared when they were young, and has increased over the years as the spinal discs and facet joints degenerate, causing the spine to become unbalanced.
When idiopathic scoliosis in adults is severe, other related problems may appear. Examples of these problems would be sciatica in one of the legs due to a herniated disc, or the narrowing of the spinal canal to the extent that it causes frequent pressure on the nerves of the lumbar area.
There are also cases of adult new-onset, or secondary, scoliosis due to degeneration of the spine over the years. This type of scoliosis usually develops in the thoracic spine and lumbar spine, due to the wear on the intervertebral discs causing the spine to become unbalanced.
How is adolescent idiopathic scoliosis treated?
Adolescents with mild scoliosis, that is to say, when the curvature is between 10 and 25 degrees, do not need treatment. However, depending on the degree of severity, their condition should be monitored with regular medical check-ups to make sure that the curve does not worsen as they grow. In addition, use of an orthopedic brace in cases of moderate scoliosis is considered one of the most effective treatment options for idiopathic scoliosis in adolescents when the curve is between 25-30 and 40 degrees.
How to know if you have mild scoliosis and how to treat it
Alternative treatments to surgery for idiopathic scoliosis
There are other treatment options besides surgery that can help improve the quality of life of a patient suffering from adolescent idiopathic scoliosis. Some of the main ones are:
1. Orthopedic supports
For adults with scoliosis, Dr. Charosky does not recommend that they wear a brace, because, "even when the patient wears it, it won’t stop the condition from progressing." However, use of an orthopedic brace is recommended for children and adolescents with scoliosis, as it can slow the progression of the curve during growth. The scoliosis specialist will take into account the degree of the spinal curvature and the evolution of the condition to decide whether or not to prescribe use of a brace.
2. Medications
In adults, medications may be prescribed to relieve pain and inflammation. Injection of medications into certain points of the spine may also be used by pain clinic professionals.
3. Physical exercises
Doing stretches, and exercise in general, can help someone with idiopathic scoliosis maintain flexibility and strength, improve their range of movement, and, above all, help keep the muscle group that holds the spine straight, the erector muscles, in good shape. Our specialized physiotherapists at IC Rehabilitation will design a physical therapy and exercise routine for the patient that considerably reduces the stress on the spine.
What is involved in surgical correction of idiopathic scoliosis?
When there is a curve greater than 40 degrees, it is considered severe adolescent scoliosis and may require surgery. These cases should be reviewed by our multidisciplinary and experienced Scoliosis Team, to assess the possible need for surgical treatment and the best timing for it according to the stage of bone growth the child is at. If surgery is needed, it can be scheduled during holiday periods so as not to interfere with the child’s school year.
During surgery, the surgeon straightens the spine with the placement of screws, using neuronavigation or robotic technology to increase the safety and accuracy of the surgery.
The surgeon straightens the spine and holds it in the correct position by joining the screws with titanium rods, following a pre-planned layout prepared with a specialized software that enables us to custom-design these implants to the patient’s measurements. The goal is to achieve an optimally straight spine, and especially, an overall balance of the patient adapted to the needs of their spine, previously studied with EOS technology.
Next, the surgeon inserts a bone graft to join several vertebrae, which helps the spine stay in its new corrected position throughout the patient's lifetime.
Recovery after surgery for idiopathic scoliosis
Postoperative recovery for adolescents with idiopathic scoliosis tends to be very quick and goes well, because even though we are dealing with a complex surgical operation, at this age, the ability to recover is strong and they have a high tolerance of pain.
In addition, developments in of surgical technology have had a lot to do with improving recovery after a scoliosis operation. In the following video, Dr. Català, who is a member of the Scoliosis Team, explains the type of scoliosis cases for which surgery is indicated, what that surgery consists of, what measures are carried out to ensure patient safety, and what the recovery process is like.
When a patient is told they need to have spine surgery for something as serious as idiopathic scoliosis, they are likely to have questions they want answered. In the article linked below, you can find more answers to the most commonly asked questions about scoliosis surgery:
Scoliosis surgery: What you need to know
If you need an evaluation of a specific case of scoliosis, don’t hesitate to contact us at Instituto Clavel for help. Don’t hesitate to contact us to request an appointment.
Categories: Spine treatments, Spine pathologies, Surgery