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.
At the Southwest Scoliosis Institute, We focus on Scoliosis Diagnosis, Treatment, & Care for our Patients
Our fellowship-trained, board-certified expert orthopedic scoliosis surgeons, Richard Hostin, MD, Kathryn Wiesman, MD, and Shyam Kishan, MD, specialize in all types of spine deformities and scoliosis pain. With our experience in research, diagnosis, treatment, and surgery for children, adolescents, and adults, the Southwest Scoliosis Institute proudly accepted recognition as being at the top of the scoliosis specialty field. Our sought-after, experienced doctors and surgical team are leaders in clinical outcomes for the spine conditions we treat. After years of providing great care and treatment, the Institute became recognized for helping thousands of patients live pain-free. Also, our team treats and cares for patients with all types of spinal conditions, from mild cases to the most severe ones.
At the Scoliosis Institute, our team of spine specialists will devise the treatment plan for the patient. Furthermore, we will base the plan on the severity of the spinal curve. However, we also determine pain severity, the location and curve degree, the patient’s age, and the type of scoliosis. Our Doctors focus on the pain and correcting any deformity causing problems associated with the curve. Large populations of patients live with pain and have daily struggles associated with spine deformities that need our help. Because of our extensive research and experience, we can often help with severe cases and help patients live pain-free enjoyable lives. Our unique perspective comes from actively conducting spine-specific research and treating very complex spine conditions. With this, we provide better surgical outcomes and patient satisfaction for both post-surgical treatment and scoliosis surgery.
Why Choose the Southwest Scoliosis Institute
In many cities, surgeons fix broken bones, but do not specialize in the care of adults and children with scoliosis; therefore, many patients must travel to other cities to obtain the benefit from Scoliosis Specialists to improve their lives. Only a handful of surgeons have extensive experience and trained to specialize in these difficult life-changing procedures. Thus, patients come to us from around the world and we delight that we can restore a pain-free life. While many patients with spinal curves believe that treatment does not exist, our practice offers medical solutions based on proven techniques and facts.
What is Scoliosis?
Scoliosis is a side-to-side three-dimensional curvature of the spine. This curve can be singular in the shape of a “C” or a double curve, shaped like an “S”. Oftentimes, this condition is diagnosed in childhood, occurring in both females and males. However, the condition mostly progresses in females, causing issues and pain later in life. This curve can cause deformity and all kinds of symptoms, including pain. The symptoms can exhibit minimal discomfort to debilitating pain. Normally, as Scoliosis progresses, the pain gets worse and body changes become more evident.
How is Scoliosis Diagnosed?
First, your Scoliosis Expert will examine your spine. He or she will observe your spine while standing, bending, and walking. Then if needed your doctor will order and review your x-ray series or films. Should your x-ray films reveal a curve in your spine, your doctor will measure it utilizing the Cobb Angle. This will determine if the curve in your spine is mild, moderate, or severe.
A Cobb angle is measured using X-ray imaging to calculate the degree of how far the curve differs from normal alignment.
Cobb angle scale:
- 10-25 degrees – mild scoliosis
- 25-40 degrees – moderate scoliosis
- 40+ degrees – severe scoliosis
What causes Scoliosis?
The causes of scoliosis are not entirely understood. In fact, according to the Scoliosis Research Society (SRS) a specific cause is not found in 8 out of 10 cases. While many cases of spine curvature could result from genetics, there is no single cause that is widely agreed upon. Therefore, our current research is so important. In our research groups, we conduct research to enhance current conservative treatments by increasing their effectiveness, better use of implants, post-surgery patient outcomes, and more. All of this research helps our team develop new treatments and improve others.
Research also motivates us to learn to predict outcomes of different types of non-surgical treatments, how different surgery techniques affect patients after surgery, devise new surgical treatments, and helps us to stretch our thought processes as a group as well. “To date, we have a number of findings, but there’s no unified theory of what causes Scoliosis curves,” says Dr. Hostin. “Thus, we don’t possess the tools to determine why one person with a curve will progress to need a complex surgical procedure, while another with a curve that’s seemingly the same reaches adulthood and doesn’t need surgery.”
Several observations do exist:
- Heredity – This curved spine condition tends to run in families with different effects in each generation, perhaps even skipping generations.
- Degeneration – Adult scoliosis can occur with disc degeneration and osteoporosis.
- Spinal cord injury – A spine deformity can appear following a spinal cord injury or trauma. Also, spinal curvature patients who had polio in the 1930s, ’40s, and ’50s may get a spine curvature as a result of paralysis.
- Congenital – A spine curvature can result from the improper formation of vertebrae during fetal development.
- Neuromuscular – Abnormal nerve or muscle function can result in a large “C” shape in the spine.
Some of the conditions below may develop Scoliosis:
- Cerebral Palsy
- Spina Bifida
- Muscular Dystrophy
Is there a scoliosis gene? Research is being conducted to identify specific genes with a nexus with curvatures of the spine in the hope that doctors could predict which curves are at the highest risk for growth. “Scoliosis might be genetic, and a result of many genes; however, it has variable penetrance, meaning that in each generation genes act differently in how strongly they are expressed, which determines how severe a curve can progress,” explains Dr. Kishan. “This condition tends to run in families, but it tends to show different effects in each generation. For instance, a mother may have a mild curve who has a daughter with a severe curve, or a mother with a severe curve may have grandchildren who then have a spine curvature, but the intervening generation didn’t show any problems.”
Our expert team of spine specialists has received many academic honors & awards and has published in several peer-reviewed journals as well as presented their work at national and international meetings. In addition, they are also members of several noted research societies, including the American Academy of Orthopaedic Surgeons, Pediatric Orthopaedic Society of North America, Scoliosis Research Society, American Orthopaedic Association, and the Growing Spine Study Group.
What are the Symptoms of Scoliosis?
A curved spine can exist as a hidden disorder with no obvious signs of curvature, or it can cause great discomfort, pain, and disability. Some patients have undetected curvature of the spine for years until the curve starts to increase in size, causing pain and difficulty. “We think of scoliosis as being a childhood disease, but in fact, most commonly, curvatures of the spine are diagnosed in the juvenile and adolescent stages of 8, 9, 10, 11, and 12 years of age,” observes Dr. Hostin. “However, adult-onset or degenerative scoliosis, which we think develops as a result of disc degeneration, probably comprises an entirely separate entity from what we commonly think of as adolescent scoliosis.” Some symptoms include:
- A shoulder blade that appears higher than the other
- A pelvis that appears tilted
- Any imbalance in the rib cage or other deformities along the back
More Advanced Scoliosis Cases:
- Back pain
- Neck pain
- Rib pain
- Difficulty breathing
- Limited movement
When doctors identify and diagnose the curvature of the spine, they can determine what type of treatment should follow, there are different treatment options for different types of scoliosis. The following are important indicators for determining the treatment:
- Spinal maturity – Does the patient’s spine show signs of growth? Does the curve show change?
- Degree and extent of curvature – How does the curve affect the patient’s lifestyle?
- Location of the curve – according to some experts, thoracic curves are more likely to progress than curves in other regions of the spine.
- Possibility of curve progression – patients who possess large curves prior to their adolescent growth-spurts become more likely to experience curve progression.
After these variables are assessed, the doctor may recommend the following treatment:
In many children, a mild spinal curve does not require treatment. However, we may wish to monitor the child every four to six months throughout adolescence. In adults with a spine curvature, X-rays are scheduled to track any progression or change.
Braces are only effective in patients who have not reached skeletal maturity. If the child continues to grow and his or her curve measures between 25 degrees and 40 degrees, the doctor may recommend a brace to prevent the curve from progressing. For example, there are many different types of braces, your doctor will help you decide the best one for your condition.
In adults and children, the two primary goals of surgery are to stop the curve from progressing and diminish spinal deformity and stop the pain. Per our policy, we recommend surgery only when necessary and all conservative treatments have been exhausted. One of the most common types of surgery for scoliosis is spinal fusion. If you would like to see how the rods and screws are placed, watch Dr. Kishan’s video below – please note, it is an actual surgery.
Some adults who were treated as children may need revision surgery. In particular, if they were treated 20 to 30 years ago before major advances in spinal surgery procedures were implemented. Oftentimes the adult patient will get new symptoms, mainly severe back pain, trouble walking, or broken hardware. Another reason for revision surgery is when the lordosis does not function correctly, like flatback syndrome. In general, the doctor may recommend surgery when there is clear evidence that the surgery will improve the quality of life.
We can help
From the first time you walk into our offices, you will feel at ease. You will talk directly to one of our expert doctors. Our doctors will take the time to listen and understand your situation and perform a detailed evaluation. The doctor will review your X-rays and other tests with you, in detail, and determine a specific diagnosis. After you become well informed, you and your doctor will plan the right treatment. Finally, if your scoliosis doctor feels surgery is not the right decision in your case, he’ll tell you that, too, and offer a nonsurgical remedy as to the first course of treatment.
If you are an adult living with scoliosis or have a child with scoliosis and need adoctor who specializes in orthopedic surgery,
call the Southwest Scoliosis Institute at 214-556-0555 to make an appointment today.