What's the deal with mild scoliosis?

Question

Today, I received a physical from my doctor and he said i had mild scoliosis. It frightened me a bit because he sounded like it wasn't a big deal. Now, understand i HATE the doctors, and things like that so -of course i took it seriously. I have to schedule an appointment to get xrays at some screenings place. I am 14 years old - what should i expect, should i be worried. Please help; i'm really on the down low right now ='(

And btw; im petrified of surgery - will i have to get surgery?!

I have no pains at all, in fact - you can't even notice it..

Is there a way to keep it the way it is, so it doesn't advance as i get older? I looked up what scoliosis surgeries include on google and most of the articles said robs, bolts, screws, incisions and a whole bunch more EW!

Help.. =(

Answer 1

Got longer than I planned, but I hope it is helpful...

Treatment of scoliosis is based on the severity of the curve (they'll measure it on your x-ray) and the chances of the curve getting worse. There are three main categories of treatment: observation, bracing, and surgery.

Adolescent idiopathic scoliosis (cause unknown) is the most common form of scoliosis. It is more common in girls than boys. In most cases, scoliosis is not painful.

If the curve is small when first diagnosed, it can be observed and followed with routine X-rays and measurements. If the curve stays <25 degrees, no other treatment is needed. If the curve is between 25-40 degrees, a brace may be recommended. If the curve is >40 degrees, then surgery may be recommended to prevent heart and lung function from being impaired or problems with pregnancy.

If your curve stays below 40 degrees until the person is finished growing, it is not likely to get worse later in life.

If you do have to have surgery, it can be scary. There are risks and benefits with every surgery, even minor procedures (I'm an OR nurse now). You/your folks will have to make an informed decision about surgery. If your curve is severe and you are not corrected it can affect your ability to breath or carry a pregnancy.

Recovery is not that bad.  The younger you are, the easier/quicker it is. On average, you'll be in the hospital 3-5 days, taking care of yourself independently or with minimal assistance in about 7-10, weight restrictions for 6 mo. It takes about 6-12 mo. to completely recover.

Talk with your physician about this. He'll prescribe weight and activity restrictions based on how he is going to the surgery (posterior approach? trans-thoracic approach?) and your lifestyle (do you have to walk a lot at school/work? carry a heavy load? need to dive to work or school? etc.).

Personally, I was braced for 10 mo. with a Wilmington jacket, had surgery to have my upper curve fused, and braced for another 10 mo. with a Boston brace while my lower curve stabilized. This all took about 3 yrs.

I'm as normally functioning as anyone (are any of us really "normal"?). I never got off schedule with school (had surgery over summer break when I was 14). Graduated college at 20 and have been an OR nurse for 16 years, one of the most physically demanding areas of nursing (lots of lifting and lots of standing in one place for long periods). I've had 2 children without difficulty (didn't even use an epidural). I love to travel (I don't set off metal detectors), yoga (though the fusion prevents some positions), and SCUBA dive. I can pretty much do anything I want...but don't tell my husband I use the scoliosis to get out of vacuuming :) I don't feel my rods, but my bottom curve does ache now and then, I'm supposed to take 1-2 Alleve at bed time, but us nurses are awful patients, so I don't do it regularly.

Are you being treated at a Shriner's Hospital/Clinic? Absolutely the best place for scoliosis patients under 18! If you are, ask the docs/nurses if they can arrange for you to visit/talk with other patients or people who will be involved in your care. Other places may do this too, but I think Shriner's goes above and beyond for their kids.

Good luck!

Answer 2

Scoliosis usually isn't that big of a deal.  Your doctor's right on that.  On the other hand, I've been through two fusions and am comfortable with my having scoliosis.  I understand how it worries people that just found out that they have scoliosis.

You should respect the disease but not be worried about it.  You'll need to see a doctor to find out how many degrees your curve measures, where it is on your spine, and whether your curve is functional or structural.

The only time you'll need surgery is if your curve increases so its more than 50 degrees, your curve is increasing really fast so that its pretty clear that your curve will get to be over 50 degrees, or if the curve is causing other problems.  So if you have a small curve, about all you need to do is monitor it every once in awhile.

There's really no 100% certain way to keep your curve from increasing.  A brace may help keep your curve from increasing but it won't reduce the curve.  Also, you can't predict how much or how fast your curve will increase.

This is going to be a really long reply because I'm combining a few replies that I've given others when they wanted info about scoliosis, a doctor's exam, and the surgery/hospital stay.

What will happen:

o Your medical history will be looked over.

o Your weight and height will be measured.

o You'll have your reflexes checked.

o You'll walk forwards and backwards on your heels and toes to check balance and nerves.

o You'll walk forward and backward normally to check your gait.

o You'll bend in all directions to check for flexibility.

o Your back will be checked for obvious signs of scoliosis.

o If you have scoliosis and don't have recent x-rays that you've brought, you will have fresh xrays taken.

o Your curve on the x-ray will be measured.

o You'll have your back examined for soreness.

o If needed, your treatment options will be discussed.

o You may get referrals for PT or pain management. You may also get a prescription for a brace if appropriate for your scoliosis.

o A pain management doctor may be asked to perform more diagnostics if you have disc problems.

o I've probably missed a few things...

I've posted the following a few times for other people with questions. I hope I'll answer the things that have you concerned.

Scoliosis comes mainly in two flavors - functional (the curve is caused by another issue (uneven leg length for example) and structural.  There are two main kinds of structural scoliosis - congenital (present at birth) and idiopathic (unknown cause).  It is important for you to know what kind you have.

If you have functional scoliosis, a chiropractor may be able to help.  Shoe lifts may help with uneven legs, but there can be many causes of functional scoliosis.  I don't have much experience with functional scoliosis.

If you have structural scoliosis, there's not a lot you can do.  The main treatments depend on how bad the curve is and how much more growth you have to go.  Its not possible to predict how much or how fast a curve may increase.

You need to see a scoliosis specialist if you're not doing that already. A doctor that is not trained as a scoliosis specialist doesn't have the expertise to treat it.

Any curve under 10 degrees is considered normal and probably isn't monitored.

Curves from 10-25 degrees are mild but should be monitored, especially if you're still growing.

Curves from 25-40 degrees are moderate with bracing possible. You will need monitoring, especially if you're still growing.

Surgery may be recommended if your curve doesn't respond to bracing. Bracing will do no good if you're through growing. The purpose of a brace isn't to make your curve better, but rather to keep the curve from becoming worse.

Curves greater than 45 degrees is major. Surgery may be recommended. This depends on many things, but whether you're done growing, whether your curve is increasing, whether your heart and lungs are in danger of being squeezed by your curve, whether you're in pain, quality of life, etc.

If your curve is over 30 degrees, there is a good chance that it will increase even when you're through growing.  (Mine did.)

Unfortunately, nothing can *fix* idiopathic scoliosis. Surgery can keep the curve from getting worse, and in most cases, will reduce the curve but most likely your spine won't be straight (unless you are very flexible in the area to be fused, then you might be lucky).

Chiropractors, message therapists, acupuncturists, etc., can't fix idiopathic scoliosis. These people adjust the soft, connective tissues and that may (or may not, you can't tell ahead of time) make you feel better, but remember, idiopathic scoliosis is not a connective tissue disease. Your spine is growing curved.

I've posted the following a few times for other people with questions. I hope I'll answer the things that have you concerned.

Let me talk about the hospital stay.

You'll have meds to help with the pain. You'