The spine is an important and complex part of the human anatomy, supporting the entire body and allowing us to move. It follows that spine disorders can have significant impact on a person's movement and functioning.
Spine disorders can affect both children and adults. The likely course of treatment depends on what condition you're diagnosed with and when it develops; treatment can range from simple observation to spinal surgery.
This post provides information on the following types of spinal deformities: scoliosis, kyphosis and neuromuscular conditions.
Scoliosis is a deformity that involves the curvature of the spine. It is a three-dimensional deformity that affects all three planes of the body — the coronal plane, the saggital plane and the axial plane. Picture a human body bisected by a plane. The coronal plane is a vertical plane that bisects the front and back part of the body. The saggital plane is also vertical, but bisects the right and left sides of the body. The axial plane is horizontal and separates the top and bottom of the body.
Scoliosis is a spine disorder that can be difficult to visualize with two-dimensional radiographs because of the nature of the curvatures it causes.
When the spine has "normal” alignment, all spinous processes — or the bony projections on the back part each vertebra — line up in a straight line over the sacrum, or the large supportive vertebra at the bottom of the spine. Vertebrae are the individual interlocking bone segments that make up the spine, and the average person is born with 33 vertebrae, some of which fuse together during development.
A spine with normal sagittal alignment is visibly balanced. A vertical line can be drawn from the midpoint of the C7 vertebra to the posterior superior — or back top — corner of the sacrum. Read more about cervical spine anatomy and lumbar spine anatomy to better visualize the parts of the spine and how it works.
Congenital and idiopathic scoliosis
A spine affected by scoliosis shows an abnormal curve or curves. Scoliosis can affect children and adults. It can be congenital — or present at birth — or idiopathic, meaning it appears spontaneously or from an unknown cause at some point during a patient's life.
Congenital scoliosis is a spine disorder that can occur when abnormal development of the spine results in:
- A missing portion
- Partial formation
- Lack of separation of the vertebrae
More boys that girls are affected by congenital scoliosis among infants, or those age 3 and below. Eighty percent of these cases resolve themselves without treatment. The means they don't require bracing or surgery.
Idiopathic scoliosis can affect infants, juveniles or adolescents. Adults who have idiopathic scoliosis usually develop the condition after adolescence — in other words, a case of adolescent scoliosis becomes an adult scoliosis when a patient ages. Adults can also develop the condition after age 40.
Research shows that idiopathic scoliosis affecting juveniles — or children aged 3 to 10 years old — affects boys and girls equally. Adolescent idiopathic scoliosis cases are 80 percent girls. Most adolescent patients with scoliosis have small curves. However, the greater the degree of curve, the more likely the progression of theses spine disorders. Also, the greater the amount of growth after the onset of the curve, the more likely the progression of the condition.
Treatment options for scoliosis can differ, depending on whether the patient is an adolescent or adult, and range from observation to spine surgery. Talk to an orthopedic expert about any concerns you have regarding scoliosis, spine disorders or deformities of the spine.
Kyphosis is a deformity affecting the sagittal plane, which divides the body into left and right segments. A spine affected by kyphosis shows evidence of a forward curvature of the vertebrae in the upper back area, giving it a "humpback" appearance.
Causes of kyphosis include:
- Metabolic problems
- Neuromuscular conditions
- Osteogenesis imperfecta — also called “brittle bone disease” — which is a condition that causes bones to fracture with minimal force
- Spina bifida
- Scheuermann's disease, which is a condition of unknown origin that causes the vertebrae to curve forward in the upper back area
Neuromuscular spine deformities result from neurologic or muscular diseases, such as cerebral palsy, muscular dystrophy or polio.
Correcting spinal deformities
There are a number of strategies that can be used to correct spinal deformity spine conditions. If spine surgery is needed, there are a number of factors that can influence the approach, including the stiffness of the curvature of the spine. A surgeon may need to reduce the stiffness of the curve before correcting the deformity.
Different surgical approaches may use wires and cables or rods and bolts, and may have different pros and cons in terms of long-term impact, stress, complexity and more. Talk to an orthopedic surgeon about what makes the most sense for your condition.
Read more about innovations in spine surgery and answers to the most frequently asked questions about spine surgery.
If you're going to have spinal surgery, there are steps you can take to be prepared for a successful procedure and recovery.