Thoracic scoliosis refers to an abnormal sideways curve located in the middle (or thoracic) portion of the spine. This is the most common location for scoliosis curves, and the first sign many patients notice is an asymmetry of the chest, rib cage and shoulder blades.
Thoracic insufficiency syndrome is a complex condition that involves chest wall deformities and can affect normal breathing and lung growth.
Thoracic scoliosis is most commonly seen in children and adolescents between the ages of 10-15, which is around the time most people go through their first major growth spurt. It may also develop later in life as a result of underlying muscle or connective tissue disorders and other degenerative conditions.
Because thoracic scoliosis affects the region of the spine that connects to the rib cage, many patients first become aware of the condition because of an asymmetry to the rib cage and shoulder blades, as well as uneven shoulder height.
Thoracic scoliosis is usually characterized by a distinctive ‘C’ shaped curve in the middle section of the spine, also known as the thoracic vertebrae. It may develop on its own, or it may develop in conjunction with lumbar scoliosis, and when this happens it typically produces an ‘S’ shape in the spine as the two curves form in different directions.
The symptoms of thoracic scoliosis differ from person to person and depend on a number of factors, such as age and stage of development of the patient, as well as the location and severity of the curve, and many more.
Some symptoms of thoracic scoliosis include:
Thoracic scoliosis is usually identified through a combination of visual inspection and X-ray imaging. During an initial exam, the physicians at Southwest Scoliosis Institute use our advanced low-dose X-ray imaging system to measure the severity of the curve.
Additional imaging tests are sometimes required, especially with cases that may require surgery. In these cases, the physician will order additional tests, such as computed tomography (CT) or magnetic resonance imaging (MRI).
In many cases, thoracic scoliosis can be addressed through a combination of observation and a brace. However, in cases where the patient’s curve has progressed to the point that they are in pain or having difficulty breathing, surgery may be the best option.
Observation. The physicians at Southwest Scoliosis Institute typically recommend observation for younger patients whose curves are less than 25 degrees. Using our in-house 2D/3D EOS imaging system, images of the spine can be taken every 4 to 6 months to determine if the curve is progressing or not while delivering an extremely low dose of radiation. This low-dose imaging system is especially beneficial for children, as they are more susceptible to the cumulative effects of radiation than adults.
Bracing. In (primarily adolescent) patients whose curve has progressed past 20-25 degrees, the physicians often prescribe a back brace to be worn until the patient reaches full skeletal maturity. Though bracing cannot correct the curvature, in many cases it can stop it from progressing. For this reason, bracing is most effective when it is started early and when braces are worn as prescribed.
Surgery. If the curve progresses beyond 40-50 degrees, the physician may recommend surgery. The most common type of surgery to address thoracic scoliosis is called spinal fusion, which involves inserting rods and screws (known as instrumentation) into the vertebrae to prevent the spinal curvature from progressing any further.
Surgeries to fix thoracic scoliosis are complex, multistep procedures, but Dr. Richard Hostin, Dr. Shyam Kishan, and Dr. Ioannis Avramis are specially trained and have years of experience performing these types of complex spine surgeries.
If you or your loved one is suffering from scoliosis, there is hope. We can help. Call Southwest Scoliosis Institute at 214-556-0565 to make an appointment.