Introduction to Spinal Curvature

Curvature of the spine is common in two forms: scoliosis and kyphosis. Scoliosisis a lateral (toward the sides) curvature in the normally straight vertical line of the spine; it may occur in the thoracic or lumbar segment of the spine, and it may or may not include rotation or deformity of the vertebrae. Kyphosis is a curving of the spine that causes a bowing of the back - usually the upper back.

Symptoms of a Spinal Curvature

Kyphosis causes a bowing of the back, seen as a slouching posture. Symptoms of kyphosis, that may be present or not, depending on the type and extent of the deformity, include mild back pain, fatigue, appearance of round back and breathing difficulties.

Those with scoliosis often do not have pain as adolescents and young adults. Pain is a common in adulthood if left untreated. The most common complaint from parents and patients is cosmetic deformity. Besides back pain and stooped posture, problems with the legs may occur such as numbness, pain, weakness, heaviness, and tingling which limit activity and make walking difficult.

Treatment Options for Spinal Curvature

The treatment of scoliosis is determined by the extent of the deformity and the stage of bone growth (how near the growth centers are to closure). Many scoliotic curves require no treatment (less than 30 degrees) but should be followed in 6-month intervals. More serious cases may require observation, exercise, a back brace, or surgery. The treatment is most successful when it is started early.

The treatment of kyphosis depends on the cause of the disorder. For kyphosis caused by poor posture, treatment may consist of exercises, a firm mattress for sleeping, and a back brace to straighten the curve until growth is complete. Bedrest is recommended for severe pain. Gradual weaning from the brace begins after maximum correction of the curve by the back brace has occurred.

Surgery may be indicated if neurological symptoms occur. Surgery is indicated when:

  • The deformity is severe (70 degrees of angle for kyphosis) or balance is significantly abnormal
  • Neurologic symptoms exist

Spinal instrumentation (medically designed hardware such as rods, bars, wires, and screws) and fusion are surgical procedures that may be used to correct spinal deformity and to provide permanent stability to the spinal column. These procedures join and the level where a spinal element has been damaged or removed. These devices hold the spine straight during fusion.

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