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, and Care for our Patients
Our fellowship-trained, board-certified orthopedic spine surgeons, Richard Hostin, MD, Kathryn Wiesman, MD, and Shyam Kishan, MD, specialize in scoliosis diagnosis, treatment, and surgery for children, adolescents, and adults. Our experienced surgical and nursing team cares for people with spine conditions — from mild to the most severe cases.
At the Scoliosis Institute, our team of specialists determines the optimal treatment for you or your child based on the severity of the spinal curve, your pain, where the curve occurs in the spine, and the age and stage of progression. Our mission is to minimize surgical risks associated with the curve of the spine, spine pain, and spinal deformity. Only a handful of U.S. surgeons have extensive experience and interest in specializing in these difficult procedures.
In many cities, orthopedic surgeons heal broken bones, but do not specialize in the care of adults and children with scoliosis; therefore, many people who could benefit from Scoliosis Specialists and their expertise are unaware of the opportunities to improve the condition and their lives. While many patients with spinal curves believe there is no treatment option available or that as an adult, their spinal problem cannot be treated, Southwest Scoliosis Institute offers new hope.
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 of 10 cases. While many cases of spine curvature are thought to be genetic, there is no single cause that is widely agreed upon. “We have a number of observations and findings, but there’s no unified theory,” says Dr. Hostin. “We’re hindered in that we can’t take all of the observations and put them into a road map that explains 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 – Scoliosis tends to run in families and presents with different effects in each generation, perhaps even skipping generations.
- Degeneration – Adult scoliosis can be caused by disc degeneration, osteoporosis or osteomalacia, a softening of the bones.
- Spinal cord injury – Scoliosis can appear following a spinal cord injury or trauma. Additionally, spinal curvature patients who had polio in the 1930s, ’40s, and ’50s may experience a spine curvature as a result of paralysis.
- Congenital – Scoliosis can result from the improper formation of vertebrae during fetal development.
- Neuromuscular – Abnormal nerve or muscle function can result in scoliosis.
- Cerebral Palsy
- Spina Bifida
- Muscualr Dystrophy
Is there a scoliosis gene? Research is being conducted to identify specific genes associated with curvatures of the spine in the hope that we will be better able to predict which curves are at the highest risk for progression. “Scoliosis is thought to be genetic, and a result of an expression of multiple genes; however, it has variable penetrance, meaning that in each generation there is variability in how strongly the genes are expressed, which determines how severe the curve is,” explains Dr. Kishan. “Scoliosis tends to run in families, but it tends to have variable effects in each generation. That is, 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 exhibit any significant 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. They are also members of several prestigious 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?
Scoliosis can be 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 and are generally taught that it is such. 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, is probably an entirely separate entity from what we commonly think of as adolescent idiopathic scoliosis.” Some symptoms include:
- One-shoulder blade that appears to be higher than the other
- A pelvis that appears to be 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 the curvature of the spine is identified and diagnosed, a determination can be made as to what type of treatment is proper. The following are important indicators for determining the treatment
- Spinal maturity – is the patient’s spine still growing, has it stopped growing, and is the curve changing?
- Degree and extent of curvature – how severe is the curve and how does it 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 have large curves prior to their adolescent growth spurts are more likely to experience curve progression.
After these variables are assessed, the following treatment options may be recommended:
In many children, the spinal curve is usually mild enough to 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 based on the patient’s evaluation to track any progression or change.
Braces are only effective in patients who have not reached skeletal maturity. If the child is still growing and his or her curve is between 25 degrees and 40 degrees, a brace may be recommended to prevent the curve from progressing. There are many different types of braces, your physician will help you decide which one is best for you and your condition.
In children, the two primary goals of surgery are to stop the curve from progressing during adulthood and to diminish spinal deformity. We recommend surgery only when necessary. A common type of surgery for scoliosis is a spinal fusion. 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. In general, surgery in adults may be recommended 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 at the Southwest Scoliosis Institute, you will feel at ease. You will talk directly to one of our expert orthopedic physicians, who will take the time to listen and understand the complexities of your situation and perform a detailed evaluation. The doctor will review your X-rays and other radiological exams with you, in detail, and determine a specific diagnosis. After you are well informed, you and your doctor will formulate the right treatment plan. If your scoliosis doctor feels surgery is not the right decision in your case, he’ll tell you that, too, and recommend a nonsurgical remedy as to the first course of treatment.
Deborah couldn’t remember a single day in her life without pain. That all changed when she had scoliosis surgery at Southwest Scoliosis Institute. Deborah had an 82-degree curve at the top of her spine and an 89-degree curve on the bottom. She was in terrible pain and suffering from other complications of scoliosis, including a chest deformity that made it difficult to breathe. She was also having a hard time walking and required a cane. “I was in so much pain, I felt like a zombie most of the time,” said Deborah. “I couldn’t work anymore. I couldn’t shop or cook.”
“I was very fortunate to have my scoliosis surgery. Recuperation went very well and without incident. After only six months, I am back to (carefully) doing what I want, including yard work and bicycling.” – Robert Wagner
“We measure our success by our patients’ expectations of success,” says Dr. Wiesman. “We commonly receive letters and pictures from our patients telling us how we have been a significant part of their recovery and how much the quality of their lives has improved.”
If you are an adult living with scoliosis or have a child with scoliosis and need a physician who specializes in orthopedic surgery,
call the Southwest Scoliosis Institute at 214-556-0555 to make an appointment today.