The primary goal of deformity surgery is to achieve a balanced spinal alignment through rigid fusion, prevent further deformity and alleviate neurological symptoms.
What are spinal deformities?
All spinal deformities involve deviation of the curve or rotation of the spine.
Type of Spinal Deformities
Kyphosis- Involve upper back curving back and form hump
Lordosis - Involve lower back Curving inward
Scoliosis- Frontal deformity in which spine deviate right or left when observe from front or back
What are risk factors for spinal deformities?
- Many cases of scoliosis have no identifiable cause. (Adolescent Idiopathic Scoliosis)
- There are a few known genetic/Congenital conditions that may put someone at risk of developing scoliosis, including cerebral palsy, muscular dystrophy, and achondroplasia, which is a condition affecting cartilage.
- For Kyphosis, risk factors include poor posture and fractures resulting from osteoporosis post infection or post injury.
- Osteoporosis is also a risk factor for Lordosis. Slipped vertebrae and obesity may also cause the condition.
- Ankylosing Spondylitis where spine fuse like bamboo spine
What are the symptoms of spinal deformity?
Symptoms differ, depending on the type of deformity. They may take the form of:
- Pain: For scoliosis, this pain may occur in the upper spine and the ribs.
- Feeling of being off balance or difficulty walking or standing: When the spine isn’t in correct alignment, the body and head aren’t either.
- Visible curve (hunched over): In kyphosis, in particular, the outer curve in the upper back may be noticeable. In scoliosis, one shoulder blade, or hip, may appear higher than the other.
- No symptoms: For some patients with mild deformities, the curves may not cause any symptoms.
How are spinal deformities diagnosed?
To diagnose a spinal deformity, a specialist will perform
- A physical examination
- X-rays of the spine- which will be x rays whole spine include both shoulder and and proximal thighs
- Magnetic resonance imaging (MRI) – usually to rule out any underlying spinal cord pathology and if any then has to address before deformity correction
- Computerized tomography (CT) scans, in order to analyze the internal bony structure of the spine and for surgical planning
What are treatments for spinal deformities?
To treat spinal deformities- aim
- relieve pain
- lighten the strains on the spine
- prevent deterioration of spinal structures such as disks and vertebrae
- ease breathing if the lungs are affected
- reduce the appearance of the deformity.
Intervention may not be needed if the deformity is not progressing and the symptoms aren’t a problem for the patient. In these cases, specialists will monitor the curve and treat when necessary. There are also several methods of physical therapies to treat spinal deformities by helping to reorient the spine and slow down the advancement of the curve
When is spinal surgery necessary?
- When curve is symptomatically compressing your organs
- if the curve continues to progress
- if the pain become severe and is unresponsive to medical and conservative care.
- Severe back pain with neurogenic radicular pain
- Neurological deterioration
Spinal surgery involves mobilizing and straightening the spine, and then placement of instrumentation with a spinal fusion in order to hold the spine in the new position and prevent further progression of the curve.
Spine surgeon use a combination of screws and rods and bones (taken from another part of the body) to encourage growth of new bones in better positions.Patients can expect to recover from this surgery within 3 months.
Are spinal deformities treated differently in children, adults, and the elderly?
Children and adults are treated differently. When treating children with spinal deformities, nonsurgical treatments are often chosen since children's bones are still developing. A brace, for example, can direct a child’s growing spine into the right alignment. In adults, the same treatment would be less effective because the spine is already rigid in its position.
In older adults, if osteoporosis is the underlying cause of the deformity, we may treat it with calcium, hormone replacement therapy, or weight-bearing exercises. Bracing is another nonsurgical option for adults. It will not change the position of the spine, but it may ease pressure and pain. Orthotics (shoe inserts) can also help reduce back pain if the legs have been affected by the spine’s changing shape.