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Scoliosis

Spine Curvature Disorders: What are the Different Types?

The backbone (or the spine), is comprised of vertebrae (small bones) that are stacked one on top of another.

Viewed from the side, a healthy spine has gentle curves on it.

These curves work by helping the spine absorb stress from gravity and body movement.

Ideally, when viewed from the back, the spine should run straight down the middle of the back.

However, when spine abnormalities occur, the natural curvatures become exaggerated or misaligned in certain areas, as evident in the 3 different types of spine curvature disorders—kyphosis, scoliosis, and lordosis.

Kyphosis

Also referred to as hunchback or roundback, kyphosis is a condition characterized by an excessive curvature of the spine in the upper back.

In elderly women, the condition is called dowager’s hump.

The spine’s thoracic region (or the upper back) typically has a slight natural curve.

The spine in the upper and lower back as well as the neck is naturally curved to help ensure the weight of the head is supported and to absorb shock.

When there is a larger than normal natural arch, kyphosis occurs.

Patients who have kyphosis may have a visible hump on their upper back.

In patients with kyphosis, the upper back may appear protruding and noticeably rounded.

Kyphosis may also cause spine pressure which can result to pain.

When pressure is also placed on the lungs, kyphosis may also cause breathing difficulties.

Causes

This condition can affect people of all ages.

Kyphosis that is secondary to poor posture is called postural kyphosis.

Other likely causes of the condition include:

  • Scheuermann’s disease (has no known cause and occurs in children)
  • Arthritis (and other bone degeneration disorders)
  • Spine injury
  • Osteoporosis
  • Aging
  • Muscle weakness (in the upper back)
  • Slipped discs
  • Spine infection
  • Tumors

Treatment Interventions

Seeking the help of an orthopaedic specialist is recommended when the condition is already accompanied by fatigue, breathing difficulties, and pain.

Treatment of kyphosis will depend primarily on two key factors—underlying cause and the condition’s severity.

Depending on the cause, the following treatment interventions are often given:

  • Scheuemann’s disease – corrective surgery, braces, or physical therapy
  • Tumors – tumors are often removed when there is possibility of cord compression
  • Osteoporosis – bone deterioration is often treated to ensure kyphosis will not worsen
  • Infection – antibiotics are often prescribed

Scoliosis

Scoliosis is characterized by an abnormal curvature of the spine.

Normally, the shape of the spine includes a curve at the lower back and at the top of the shoulder.

However, if the spine is curved from side to side in a “C” or “S” shape, there is a huge possibility the patient has scoliosis.

Scoliosis is often categorized into two—structural and nonstructural.

In the former, the curvature of the spine may be caused by injury, disease, or a birth defect. It is also considered permanent.

The latter on the other hand pertains to temporary curves that can still be fixed.

Causes

According to the American Association of Neurological Surgeons (AANS), there is no known cause for at least 80 percent of scoliosis cases.

However, some of the likely causes can include:

  • Cerebral Palsy – a nervous system disorder that can affect learning, seeing, thinking, hearing, and movement
  • Muscular dystrophy – a genetic disorder that often causes muscle weakness
  • Spinal infection or injuries
  • Birth defects that affect an infant’s spinal bones (for instance, spina bifida)

Treatment Interventions

Recommended treatment intervention for scoliosis will depend on several factors.

However, the degree of the spine curvature is considered a primary one.

When identifying the ideal treatment option, other key factors that are taken into account include:

  • Patient’s age
  • Type and degree of curvature
  • Type of the scoliosis

Two of the primary treatment options for scoliosis are bracing and surgery.

Bracing

Bracing is often the recommended option in the following scenarios:

  • The patient is still growing and the curvature is more than 25 to 30 degrees
  • The patient is still growing and the curvature is already between 20 and 29 degrees (and the curvature is worsening)
  • The patient has at least 2 more years to grow and the curvature is between 20 and 29 degrees

Using braces will not straighten the spine.

It is used to prevent the curvature from worsening.

This treatment intervention is effective in cases where the condition has been detected early.

Surgery

Surgery is the recommended treatment intervention for patients who have curves greater than 45 or 50 degrees.

It may also be resorted to when the condition already affects the patient’s way of life and is already causing discomfort.

The standard scoliosis surgery is spinal fusion.

The procedure involves fusing the vertebrae together with the use of bone grafts, screws, and rods.

Lordosis

Normally, the spine is curved a little in the lower and upper back and the neck.

The curves are designed to help the body:

  • Absorb shock
  • Support the head’s weight
  • Align the head over the pelvis
  • Bend and move flexibly

Lordosis occurs when the curves arches too far inward.

The condition is also known as swayback.

Since the condition affects the neck and lower back, it can result to excess pressure on the spine, causing discomfort and pain.

Left untreated, it can also affect the patient’s ability to move.

Causes

While the condition can affect people regardless of age, certain factors and conditions can increase one’s risk.

These factors include:

  • Lower back trauma
  • Poor posture
  • Obesity
  • Discitis (inflammation of the space between the vertebra)
  • Osteoporosis (loss of bone density)
  • Spondylolisthesis (occurs when one vertebra slips forward and does not align)
  • Achondroplasia (a form of dwarfism)

While rare, muscle problems and conditions related to the nervous system may also cause lordosis.

These conditions include:

  • Muscular dystrophy
  • Cerebral palsy
  • Myelomeningocele
  • Anthrogryposis
  • Spinal muscular atrophy

Treatment Interventions

Unless severe, lordosis will not require treatment.

The chosen treatment option will depend on the presence of other symptoms and the severity of the curvature.

Possible treatment interventions include:

  • Medication – to minimize swelling and pain
  • Physiotherapy – to improve motion range and strengthen the muscles
  • Weight loss – to help improve posture
  • Braces – often recommended for teens and children
  • Surgery – often recommended in severe cases (with neurological concerns)

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