Scoliosis

Most people typically think of scoliosis as a childhood disease. In fact, scoliosis is commonly diagnosed in the juvenile and adolescent stages—ages 9, 10, 11 or 12. There is, however, adult-onset or degenerative scoliosis, which develops as a result of disc degeneration that is different from adolescent idiopathic scoliosis.

Scoliosis is thought to be genetic and tends to run in families. However, with each generation, there is a variability of how strongly the genes that cause scoliosis are expressed, which determines how severe the curve of the spine may be. For example, a mother may have a mild curve, but her daughter may have a very severe curve. Similarly, a mother may have a severe curve, and her grandchildren may develop scoliosis, but their parents did not.

What we know about scoliosis is constantly changing. In the past, the accepted teaching was that once a patient reaches adulthood, their curves become static and do not progress. For many patients, this is true. However, there is a subgroup of individuals whose spinal curves continue to progress during adulthood. Years ago, physicians were taught that a 50-degree thoracic curve typically does not increase in adulthood, but now we know that it can progress in some cases. There has been an evolution in what is known about scoliosis, but many general practitioners, internal medicine specialists and pediatricians do not have access to the latest information, which makes care much more difficult and challenging for their patients.

With adults, the prognosis can be more complicated. We typically see adult patients, particularly women, who fall into one of several categories:

Young women with very large curves who have no pain
In these patients, the probability of the disease progressing is 80 or 90%, and if it goes untreated, they may experience problems in later life. With these women, we discuss their treatment options on a case by case basis.

Young women with a history of scoliosis who were advised their curves would not progress in adulthood
These scoliosis patients typically did not experience back pain and were told their curve was stable. However, many of these women go on to experience back pain symptoms during and after their second pregnancy. The primary hormone produced during pregnancy is progesterone, which may cause their scoliosis to progress. Also during pregnancy, the ligaments and joints become loosened in order to allow the pelvis to develop appropriately. During this time, a woman’s curve may start to progress leading her to experience pain from her scoliosis.

Women with a small curvature of the spine that progresses throughout adulthood
In these cases, the progression of scoliosis does not seem to be related to pregnancy. Rather, in middle age, the patient experiences some spinal deformities, which causes her clothes to fit differently and alters her physical appearance. The back pain in such cases usually progresses and severely affects the woman’s quality of life.

Pain prevention is one of the main reasons your scoliosis should be treated. Back and leg pain can be disruptive and unrelenting. It not only affects an individual’s personal and emotional life, but it can have major effects in many other aspects as well. Our most important job is to find surgical solutions to attempt to remove or alleviate pain caused by scoliosis.

Scoliosis treatment technology has changed very rapidly, and there are ways to treat patients now that weren’t available in the past. Unfortunately, there is a lack of education, even in the medical community, about concerning the treatment of scoliosis. The orthopedic physicians here are often featured speakers at national conferences and events to help educate pediatricians, primary care physicians and internal medicine specialists to help and to clarify some of the misinformation.

The core strength of the Baylor Scott & White Scoliosis Centers is its staff. We have a dedicated group of individuals, including anesthesiologists, nurses, spinal cord monitoring individuals personnel and implant specialists that work with the surgical team. Our operating time, and our time for each case, has decreased, and the benefit to the individual patient is that their outcomes are better.

Plus, in an era when a lot of many patients report that their doctors' offices are very impersonal, we have managed to preserve our emphasis on patient care and personal treatment.

Scoliosis patients typically bring two things to their initial office visit: the physical pain their scoliosis is causing and the emotional toll it is taking on them. One of the most rewarding parts for our team is helping patients manage the emotional issues they are enduring: how they feel about themselves and how they feel about their cosmetic appearance. In an effort to help provide our current patients with additional emotional support, we connect new patients with previous patients who are in various stages of their journey.

There's been a dramatic explosion in the amount of research that is conducted in the field of scoliosis treatment. The goal of this research is to further understand the causes of scoliosis and the most beneficial clinical treatments. We're learning more and more about the fundamental molecular, genetic, and foundational causes of this disease. The future of scoliosis treatment lies in early genetic diagnosis and biopharmaceutical treatment of the growth abnormalities that can lead to the curvature of the spine. Learn more about clinical trials and research activities at the Baylor Scott & White Scoliosis Centers across North and Central Texas in Dallas, Plano, Lakeway and Round Rock.

The bones of the spine are arranged to give the spinal column stability. Damage or defects within the supporting structures of the lumbar spine (the lower part of the back) can often be the source of back pain resulting from:

• Herniated disc
• Scheuermann's kyphosis spinal stenosis
• Spondylolysis and spondylolisthesis