Spine Deformities

Scoliosis can occur at any age. The cause of scoliosis is not known in 80% of cases. This is referred to as idiopathic scoliosis. Dr Hsu and Dr Singh will investigate other possible causes before diagnosing you with idiopathic scoliosis. Scoliosis causes are categorised into two groups:

Non-Structural Scoliosis: This type of scoliosis presents as a structurally normal spine with a temporary or changing curve.

Causes include:

• Differences in leg lengths
  
• Muscle Spasms
  
• Inflammatory conditions such as appendicitis

• Birth defects
  
• Injury to the spine
  
• Infections
  
• Neuromuscular diseases such as cerebral palsy and muscular dystrophy
  
• Tumors
  
• Connective Tissue Disorders
  
• Rheumatic Diseases
  
• Scoliosis Treatments

Treatment of scoliosis is based on Dr Hsu or Dr Singh’s assessment of the spinal curve, its cause, the age of the patient, and how much more the patient may grow. Treatment options include:

Observation:
Dr Hsu or Dr Singh may want to see you every 4-6 months to monitor the curve if your scoliosis is mild with a curve of less than 25 degrees.

Bracing:
Dr Hsu or Dr Singh may recommend wearing a brace to prevent the curve from worsening while the patient is still growing or if your curve is greater than 30 degrees.

Surgery:
If the patient is still growing and the curve is over 40 degrees, or is worsening, surgery may be recommended. The most common surgical procedure for Scoliosis is correction, stabilization, and fusion of the curve.

Causes of lordosis include:

• Spondylolisthesis: this condition occurs when one vertebra slips forward in relation to an adjacent vertebra causing misalignment and potential entrapment of the spinal nerves. This condition can be congenital (present at birth) or can develop in childhood or adulthood.
  
• Discitis: Inflammation of the intervertebral disk or disk space.
  
• Achondroplasia: a bone growth disorder causing the most common type of dwarfism.

The goal of treatment for lordosis is to stop the progression of the curve and prevent deformity from occurring. Treatment for lordosis is dependent on the severity of the condition, the patient’s age, and if there are any neurological deficits present. Treatment options include the following:

• Observation: Your NSWSS spinal surgeon may want to see you every 4-6 months to monitor the curve if your lordosis is mild.
  
• Physical Therapy: Dr Hsu or Dr Singh may recommend referral to a physical therapist to instruct you on a home exercise program to increase your range of motion, flexibility, and strength.
  
• Analgesics and Anti-inflammatory Medications: Medications to relieve pain and reduce inflammation may be prescribed by your NSWSS spinal surgeon.
  
• Bracing: Dr Hsu or Dr Singh may recommend wearing a brace to prevent the curve from worsening while the patient is still growing.
  
• Surgery: If the lordosis is severe, neurological involvement is present, and no relief from non-surgical treatment is obtained, surgery may be recommended.

Causes of kyphosis include:

• Osteoporosis: Compression fractures can occur in the vertebrae as a result of osteoporosis leading to Kyphosis.
  
• Scheuermann’s Disease: Also referred to as adolescent Kyphosis, this disease causes adjacent vertebra to wedge together leading to Kyphosis.
  
• Spondylolisthesis: This condition occurs when one vertebra slips forward in relation to an adjacent vertebra causing misalignment and potential entrapment of the spinal nerves. This condition can be congenital (present at birth) or can develop in childhood or adulthood.
  
• Arthritis
  
• Disc Degeneration: As people age, vertebral discs can lose moisture and shrink leading to Kyphosis.
  
• Injury to the spine
  
• Infections such as tuberculosis and polio.
  
• Birth Defects such as Spina Bifida.
  
• Inherited Disorders such as muscular dystrophy and neurofibromatosis.

Treatment for Kyphosis will depend on the cause of the condition. Treatment options include:

• Bracing: If the cause of Kyphosis is Scheuermann’s disease, Dr Hsu or Dr Singh may recommend wearing a brace to prevent the curve from worsening while the patient is still growing.
  
• Physical Therapy: Your NSWSS spinal surgeon may recommend referral to a physical therapist to instruct you on a home exercise program to increase your range of motion, flexibility, and strength.
  
• Medications: If the cause of Kyphosis is osteoporosis, Dr Hsu or Dr Singh may recommend medications to prevent future compression fractures. Kyphosis caused by infections or tumours will also require medications for treatment.
  
• Surgery: Dr Hsu or Dr Singh may recommend surgery if your kyphosis is debilitating and painful and does not respond to conservative treatment methods. Congenital kyphosis, occurring at birth, usually will require surgery at an early age. Patients with Scheuermann’s disease with a large, painful curve over 60 degrees may also require surgery.