DEXTROSCOLIOSIS

Dextroscoliosis is an abnormal curvature of the spine that bends to the right and away from the heart.

3 percent of individuals with progressive curvature may eventually experience severe problems that can include scoliosis and back pain, spinal problems, and nerve compression causing numbness, weakness, and leg pain.

What is Dextroscoliosis?

Dextroscoliosis is a type of scoliosis whereby there is an abnormal curvature of the spine. Although doctors can find abnormal curvatures anywhere in the spinal column, dextroscoliosis usually occurs in the middle and upper parts of the thoracic spine. Scoliosis refers to an abnormal rotated sideways curvature in the spine. Within this rotation, we have different types of scoliosis that can develop. These vary in cause, location, and direction in which the curve bends. Dextroscoliosis is the abnormal curvature that bends to the right. This is a form of scoliosis in which the curve bends away from the heart.

The spine specialists at Southwest Scoliosis and Spine Institute are focused on treating dextroscoliosis (and many other forms of scoliosis) in the most conservative, effective, and patient-centered manner possible.

If the patient has ‘lumbar dextroscoliosis, it means the curvature developed in the lumbar part of the spine and curves in the right direction. If the patient has ‘thoracic dextroscoliosis, then the curve developed in the patient’s thoracic spine curves in the right direction.

Questions and Answers

What causes Dextroscoliosis

Dextroscoliosis, like other forms of scoliosis, can have various causes. It can develop due to congenital factors (present at birth) or as a result of other conditions such as muscular dystrophy, cerebral palsy, or spinal injuries. Idiopathic scoliosis, where the cause is unknown, can also lead to dextroscoliosis.

What are the Symptoms of Dextroscoliosis

The symptoms of dextroscoliosis can vary depending on the severity of the curvature and individual factors. Some common signs and symptoms may include:

Visible curvature of the spine, which can be noticed when the individual bends forward.
Uneven shoulders or waistline.
Back pain or discomfort.
Fatigue or muscle strain, particularly after prolonged periods of standing or sitting.
Limited mobility or stiffness in the spine.
In severe cases, breathing difficulties or organ compression may occur, although this is less common.

How is Dextroscoliosis Diagnosed and Treated

How is dextroscoliosis diagnosed and treated? Diagnosis typically involves a comprehensive evaluation that may include:

Medical history assessment: The doctor will inquire about symptoms, family history, and any relevant medical conditions.
Physical examination: The doctor will examine the spine, looking for signs of curvature, symmetry, and range of motion.
Imaging tests: X-rays, CT scans, or MRI scans may be ordered to obtain detailed images of the spine, helping to determine the severity and extent of the curvature.

Treatment for dextroscoliosis is dependent on factors such as the degree of curvature, age, overall health, and associated symptoms. Mild cases may require observation and monitoring to ensure the curvature does not progress. For more significant curves or cases with symptoms, treatment options may include:

Bracing: Customized braces can be prescribed to help prevent further progression of the curvature, particularly in growing adolescents.
Physical therapy: Targeted exercises and stretching can help improve posture, strengthen muscles, and reduce pain associated with dextroscoliosis.
Surgery: In severe cases, where the curvature is significant or causing severe symptoms, spinal fusion surgery may be recommended. This procedure aims to correct the curvature and stabilize the spine using rods, screws, or bone grafts.

Understanding Right Lumbar Scoliosis Curve

A right lumbar scoliosis curve is a specific type of spinal curvature where the spine bends sideways to the right, specifically in the lower back or lumbar region. This creates a noticeable C-shape on the right side of the lower spine.

Here’s a breakdown of the key points:

Location: This curvature occurs in the lumbar area, which includes the lower part of your back.
Direction: The spine deviates to the right side.
Appearance: It typically forms a backward “C” shape.

How it Differs from Other Types

To better understand, let’s compare it with other forms of scoliosis:

Right Thoracic Curve: Bends to the right in the upper back (thoracic region).
Right Thoracolumbar Curve: Starts in the upper back and extends to the lower back, bending to the right throughout.
Double Major Curve: Consists of two curves: one curving to the right in the thoracic region and another to the left in the lumbar region.

In conclusion, a right lumbar scoliosis curve is a specific spinal deformity affecting the lower back, characterized by its rightward bend. This condition is distinct from other types of scoliosis based on its location and direction.

Dextroscoliosis vs. Thoracolumbar Curve: Understanding the Differences

Dextroscoliosis

Definition: Dextroscoliosis refers to a sideways curvature of the spine that bends to the right.
Location: While it can occur anywhere in the spine, it’s most commonly found in the thoracic (upper back) region.
Direction: The curve is always directed to the right side.

Thoracolumbar Curve

Definition: A thoracolumbar curve is a spinal curvature that affects both the thoracic (upper back) and lumbar (lower back) regions.
Location: It spans across a larger section of the spine compared to a localized curve.
Direction: The direction of the curve can be either to the right (dextroscoliosis) or to the left (levoscoliosis).

In summary

Dextroscoliosis specifically refers to the direction of the spinal curve (to the right).
Thoracolumbar curve describes the location of the curve (spanning the thoracic and lumbar regions).

Thoracolumbar Curve Definition

It’s important to note that a person can have a thoracolumbar curve that is also a dextroscoliosis if the curve in that region bends to the right.

A right thoracolumbar scoliosis curve is a type of spinal curvature where the spine bends sideways to the right, spanning from the upper back (thoracic region) to the lower back (lumbar region). Instead of the spine maintaining a straight line, this curve creates a distinct sideways “S” shape that can be visualized if you were to draw a vertical line down the center of the back.

To break it down further:

Thoracic Region: This is the upper part of the back, where the spine naturally has a slight backward curve. In right thoracolumbar scoliosis, this area bends to the right.
Lumbar Region: This is the lower part of the back. The sideways curve continues into this area, maintaining its rightward bend from the thoracic region.

Understanding this specific curve requires recognizing how it deviates from normal spinal alignment, affecting both the upper and lower sections of the spine to the right.

Causes of Dextroscoliosis

Research has shown that there are various causes of Dextroscoliosis. Most are idiopathic, i.e. there is no known cause. This form is found in 80 percent of the patients. Medical researchers also suspect that some patients may have a genetic connection to idiopathic scoliosis. Thirty percent of patients with idiopathic scoliosis also have family members with scoliosis. Apart from idiopathic scoliosis, the following provides some of the causes of dextroscoliosis:

Congenital scoliosis

This is caused while the fetus is developing and affects one in 10,000 births. Patients with this also have issues with kidney and heart functions.

Neuromuscular scoliosis

This results from conditions like cerebral palsy, muscular dystrophy, or spinal cord injury.

Degenerative scoliosis

This develops in older adults. It is caused by arthritis, ankylosing spondylosis, osteoporosis disc degeneration, and vertebral compression fractures.

Symptoms of Dextroscoliosis

Identifying scoliosis early can be crucial in managing its progression. One of the initial signs often noticed is an uneven appearance, particularly when it comes to clothing. You might observe that shirts or jackets hang unevenly, signaling a possible imbalance in the spine. Another telltale sign is a noticeable tilt of the body to one side. This tilt might be subtle at first but can become more apparent as the spinal curve progresses. Additionally, you might see one shoulder blade sticking out more than the other, or an uneven waistline.

Early detection often comes from keen observers, such as parents, teachers, or even the individuals themselves. Regularly checking for these signs can ensure timely medical consultation and intervention. People living with dextroscoliosis may show the following:

Uneven shoulders in the height
One of the shoulder blades will protrude out further than the other
The ribs on one side of the body will protrude out more than those on the other side
Uneven waistline and hips
Curve to the spine
Body tilt (the upper body will lean to one side)
Head tilt (the head will lean more to one side)

People with scoliosis that have severe degree curves can sometimes have their curved spine pressing on other organs and body areas. This can lead to serious symptoms like:

Difficulty and breathing and shortness of the breath
Back pain
Chest pain
Leg pain
Difficulties with going to the bathroom

We’re here to help STOP THE PAIN
Call 214-556-0555 or Email Us to make an appointment with our expert scoliosis doctors.

Diagnosis of Dextroscoliosis

Just as it is with all forms of scoliosis, dextroscoliosis is diagnosed by a doctor while conducting a physical examination. This examination usually includes:

Checking to see if both sides of your shoulder, waist, and hip are even or uneven.
Checking both sides of your rib cage to detect if one side protrudes out more than the other side.
Inspecting your spine from the back.
Checking your spine while bending forward with your feet together, knees straight, and arms hanging down.
Taking the X-rays of your spine to see where the curve is, and to know the extent of the curve or curves.

Depending on the outcome of the examinations above, your doctor may also ask you to have a CT scan or an MRI scan to further evaluate the spine.

How Does Dextroscolosis Progress and What Are Its Effects?

As scoliosis advances beyond a 20-degree curvature, noticeable changes often occur. For instance, clothing may start to hang unevenly or the body might tilt to one side, catching the attention of parents, teachers, or peers.

While idiopathic scoliosis typically does not cause substantial pain, especially in adolescents and young adults, the condition can lead to trunk imbalances. These imbalances may result in muscle spasms and other related issues. Consequently, some individuals experience discomfort or pain due to these secondary complications.

Dextroscoliosis Treatment Options

When it comes to treating dextroscoliosis, the first treatment step is to tackle the presence of another condition that may cause the problem and provide corrective treatment. This may sometimes involve referring the patient to a specialist that treats such medical issues. Once doctors diagnose and correct the problem our doctors can then focus on treating the curvature of the spine.

Here at the Southwest Scoliosis and Spine Institute, our experts have been treating scoliosis-related issues for many years and they are adept at suggesting the appropriate course of treatment depending on the patient’s symptoms and the condition of their spine.

Considerations

We consider the following factors before choosing a specific treatment:

Sex: Girls have a higher chance of having spinal progression than boys.
The severity of the curve: Before recommending treatment, our scoliosis experts will carry out a detailed exam of the patient’s condition to determine the stage and size of the curve.
The pattern of the curve: Increasing spinal complexities can make the treatment procedure multistep.
Location of the curve: We will analyze the actual location of the curve and then begin treatment. Curves that are found in the center of the spine are often more complex than those found in the upper or lower portions of the spine.
Maturity: We also consider the type of curve and its potential progression for proper treatment.

The dextroscoliosis treatment options include:

Non-surgical treatment

If the patient’s curve in the spine measures less than 25 degrees and it is not growing at a rapid rate, the doctor will take X-rays and other imaging tests every 6 to 12 months to monitor the condition of the spine. If the spinal curves measure between 25 and 45 degrees, the doctor may recommend supporting the spine with bracing. Although this will not correct the spine, it will help to prevent the curves from getting worse.

Another form of non-invasive dextroscoliosis treatment involves physical therapy treatment. Our doctors often recommend physical therapy where the therapist knows how to treat people with scoliosis. Physical therapy will not cure scoliosis but it can build muscles to help support a curved spine.

Non-surgical techniques for treating dextroscoliosis, a type of scoliosis where the spine curves to the right, focus on managing symptoms, preventing progression, and improving function. The choice of treatment depends on the severity of the curve, the age of the patient, and the risk of progression. Here are detailed descriptions of various non-surgical approaches:

Bracing

Indication: Typically recommended for children and adolescents whose bones are still growing and who have moderate curves (usually between 25 and 40 degrees).

Types of Braces:

Thoracolumbosacral Orthosis (TLSO): Covers the torso, excluding the neck and head. Common models include the Boston brace.
Milwaukee Brace: A full-torso brace that includes a neck ring, used for curves located higher in the spine.
Charleston Bending Brace: Worn at night, designed to bend the spine in the opposite direction of the curve.

Mechanism: Braces work by applying pressure on the curve, preventing it from worsening. They do not typically correct existing curves but can maintain them during growth spurts.

Physical Therapy

Goals: Strengthen the muscles around the spine, improve posture, increase flexibility, and reduce pain.

Common Techniques:

Schroth Method: A specialized scoliosis exercise program that focuses on de-rotating, elongating, and stabilizing the spine in a three-dimensional plane through exercises tailored to the patient’s curve pattern.
Core Strengthening: Exercises to strengthen the abdominal and back muscles, which support the spine.
Stretching: To improve flexibility and relieve tight muscles, particularly on the concave side of the curve.
Manual Therapy: Hands-on techniques, including massage and joint mobilization, to relieve pain and improve mobility.

Yoga and Pilates

Benefits: Improve flexibility, strength, and posture, which can help manage symptoms and improve overall spinal health.

Recommended Practices:

Yoga: Poses that focus on elongating the spine, improving posture, and strengthening core muscles.
Pilates: Exercises that emphasize core strength, spinal alignment, and overall body control.

Observation and Monitoring

Indication: For mild curves (less than 20 degrees) in growing children and adolescents, and for adults with stable curves.

Approach: Regular check-ups with a healthcare provider to monitor the curve’s progression through physical exams and periodic X-rays.

Pain Management

Methods:

Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.
Heat and Cold Therapy: Applying heat to relax muscles and cold to reduce inflammation.
Acupuncture: Can provide pain relief for some individuals by stimulating specific points on the body.

Lifestyle Modifications

Recommendations:

Ergonomic Adjustments: Ensuring that workspaces, seating, and sleep environments support good posture and reduce strain on the spine.
Regular Exercise: Engaging in low-impact activities like swimming, which can improve overall fitness and spinal health without putting undue stress on the back.

Orthotic Insoles

Purpose: Address leg length discrepancies or abnormal gait patterns that may contribute to spinal curvature.

Education and Support

Importance: Educating patients and their families about dextroscoliosis, its progression, and the importance of adherence to treatment plans can improve outcomes. Support groups and counseling can provide emotional support and practical advice.

Combining these non-surgical techniques, tailored to the individual’s needs, can effectively manage dextroscoliosis and improve quality of life. Regular follow-up with healthcare professionals is essential to monitor progress and adjust treatments as necessary.

Surgical Treatments

In more severe cases, where the spinal deformities continue to progress and lead to complications, surgical intervention might become necessary.

Our doctors may suggest surgery for dextroscoliosis if your spinal curves are:

Growing and getting larger with time
Severe
Leading to other problems, like breathing or other problems
Causing severe deformities

Spinal fusion

In this surgical procedure, your spine surgeon will strengthen the spinal bones that form the curve. The surgeon will then fuse them into the correct position with the help of a bone graft and sometimes screws and rods to support them.

Metal rods

Your surgeon can anchor one or two metal rods to the spine above and below the spine area with the curvature. The metal rod(s) stay in place with wires, screws, or hooks. If a growing rod gets used, the spine surgeon can extend the rod by using minor surgery.

Hemivertebra removal

This involves the removal of one portion of one vertebra to reduce the curve’s severity. The surgeon can then add a metal implant.

Customized Dextroscoliosis Treatment

We design dextroscoliosis treatment based on the specific needs of each patient. This strategy impacts our treatment success rates and produces extra great outcomes. Basically, our successes exist because we are able to provide fully customized treatments that tackle their specific symptoms and unique conditions.

Our cutting-edge treatment plans and facility, including a scoliosis-specific x-ray system (EOS), coupled with our scoliosis experts’ experience and knowledge in treating scoliosis help us get the desired outcomes and our patients back to living the life they want to live.

Complications of Untreated Dextroscoliosis

Rotoscoliosis is a severe form of idiopathic scoliosis, characterized by a sideways spinal curve with significant rotation. This twist in the spine can cause various complications due to its structural impact on the vertebral column. The seriousness of rotoscoliosis varies, but in severe cases, it can harm the spinal canal, nerves, and even cause fractures. Early detection and correct treatment are crucial, particularly for adolescent scoliosis cases, as they can include braces or surgery.

There are no complications for mild conditions. However, the following can occur for severe curves:

Breathing problems if the curve changes the shape of the chest and exerts pressure on the lungs or reduces the expansion of the lung for breathing.
Chest pain caused by the deformity of the trunk.
Problems with bowel or bladder control if the curve compresses the spinal nerves that lead to the organs.
Back or leg pain if the spinal curve compresses the spinal nerves.
Trouble walking.

Parents and caregivers need to understand rotoscoliosis well to offer proper support. Severe cases, although rare, can seriously affect a child’s spine. Seeking medical attention as early as possible is important to manage the condition and mitigate these potential complications.

Schedule Your Dextroscoliosis Consultation Today

Finally, the board-certified experts at Southwest Scoliosis and Spine Institute will provide the right spinal care and treatment for your dextroscoliosis to improve your quality of life. Schedule your dextroscoliosis consultation today by calling 214-556-0555. Patients should choose to seek treatment for scoliosis pain at specialized centers that offer expertise in the diagnosis and treatment of this condition. Such centers like the Southwest Scoliosis and Spine Institute with offices in Dallas, Plano, and Frisco, Texas offer a multidisciplinary approach to treatment, which involves a team of specialists, including orthopedic surgeons, physical therapists, and pain management specialists.

Additionally, the Southwest Scoliosis and Spine Institute offers access to advanced diagnostic tools and treatment options, such as minimally invasive surgery and spinal fusion. Patients may also benefit from a personalized treatment plan that takes into account their unique needs and medical history. Ultimately, the decision to seek treatment at a particular medical institution will depend on various factors, but for those wanting to get the very best treatment and care, the Southwest Scoliosis and Spine Institute should be considered your first choice.

____________________

Medical News Today: Dextroscoliosis

If you are an adult living with scoliosis or have a child with this condition and need a doctor who specializes in orthopedic surgery,
call the Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment today.