Is a Spinal Deformity causing my neck or back pain?
Is a Spinal Deformity causing my neck or back pain?
Spinal Deformities Overview
Being one of the main structural supports of the body, our spine is genetically designed to grow in a certain direction and with a certain amount of curvature. When viewed from the front, a healthy spine will appear straight up and down. When viewed from the side, it will adopt a gradual s-curve, bending backward from where the head sits on the neck, continuing its arc through the center of the chest, and curving slightly forward on the lumbar spine. When this typical development does not occur as a child, or the curvature of the spine is disrupted in later life, it can result in what we refer to as a spinal deformity.
The phrase “spinal deformity” is a categorical term that can be subdivided into many specific conditions. In general, this term refers to any condition of the spine that results in an unnatural curve or shape. The causes and effects of this abnormal curvature can differ in source, direction, and severity. For example, take kyphosis. Kyphosis is the exaggerated backward curve of the upper back that is sometimes referred to as “hump-back.” Kyphosis can occur as a result of congenital, degenerative, surgical, or pathological (disease-induced) reasons. So, for one person, their kyphosis may occur as a result of the age-related degeneration and compression of their spine over time. For another person, their kyphosis may result from damage to the vertebrae following an accident or fall.
Whatever the cause of the spinal deformity may be, the physicians at The Advanced Spine Center are here to help you address it. Dr. Jason E. Lowenstein specializes in the diagnosis and treatment of spinal deformities, and has been recognized as a Top Doctor for scoliosis correction. Contact The Advanced Spine Center today to set up an appointment with our award-winning doctors.
Types of Spinal Deformities
Spinal deformities are usually characterized according to the type of abnormal curvature that the spine adopts. The most common of these include:
Kyphosis: Kyphosis is a spinal deformity characterized by an exaggerated backward curve of the thoracic spine (upper back). Sometimes referred to as “Dowager’s hump” or “hump-back,” this condition is most often associated with osteoarthritis and old age and is seen frequently in older adults, especially females.
Lordosis: Lordosis, also called “swing back,” is an exaggerated forward curve of the lumbar spine (lower back). This condition results in the appearance of the abdomen jutting forward, and the buttocks jutting outward. Lordosis is less common, and can be triggered by obesity, excessive kyphosis, and spondylolisthesis.
Scoliosis: Scoliosis is a more common condition, characterized by a sideways curvature to the spine. Described as an S-curve, the onset of scoliosis most often occurs before puberty. Signs of scoliosis include uneven hips, protrusion of one of the shoulder blades, uneven shoulders, and eventual twisting of the spine.
Flatback: Flatback is a condition in which the natural curve of the lower back diminishes. This leads to a straight, or flat lower back that cause a ripple effect in the upper spine. Individuals may appear hunched over and tightness can occur in the hamstrings as their spine compensates for the lack of low back curvature.
Scheuermann’s Disease: This condition appears in children and adolescents. Like kyphosis, this disease causes an exaggerated hump in the thoracic spine. Rather than caused by degeneration, however, it is caused by disruptions in the growth of the bones in the first place. This condition can lead to considerable pain and disability.
Post-Surgical Deformity: Spinal surgery can also result in a variety of deformities. This can occur if the surgery, especially spinal fusion surgery, was unsuccessful in fully fusing the bones or if it did not heal correctly. Surgical failure can result in further curving of the spine with concurrent pain and stiffness in the surgical location.
Worried that you might have one of the conditions listed above? Our board certified team of orthopedic spine surgeons ranks among the best spinal deformity surgeons in the world!
Diagnosing Spinal Deformities
With a variety of causes leading to spinal deformities, the signs and symptoms of these conditions can also vary significantly. Symptoms will especially depend upon the type and severity of the spinal deformity that is present.
For some, the condition will exist without any symptoms at all. Further, pain is not a major symptom of spinal deformities unless the deformity is caused by arthritis, fractures, or other inflammatory conditions.
One of the main diagnosing factors is that, unlike other spinal conditions, spinal deformities can often be detected externally. Others will be able to notice the condition, which can aid in a speedier diagnosis. This visibility, however, can also be alienating to the person experiencing the deformity. The psychological effects of a spinal deformity can be a challenging aspect of the condition, especially for teenagers or young adults who may be dealing with scoliosis.
Although many spinal deformities can be seen by the naked eye, imaging techniques such as X-rays, MRIs and CT scans will often also be used to help gather information. Your physician will use these images to fully view the spine and the conditions causing the abnormality. This detailed information can be used to develop a plan for treating the condition.
If the deformity is causing compression of the spinal cord, or the spinal nerves, then pain and other distressing symptoms may be experienced. Localized pain, radiating pain to the limbs, numbness, stiffness, limited movement, tingling, and even compression of internal organs or loss of bladder or bowel control can be experienced. These symptoms may require surgery in order to rectify, especially if one is experiencing bladder or bowel incontinence. Please seek immediate medical attention if you are experiencing loss of movement, paralysis, or loss of bowel or bladder control, as this may be a medical emergency.
Spinal Deformities Treatment Options
Most often used for conditions such as scoliosis and kyphosis, your physician will use rods, plates, and screws to mechanically join one or more vertebrae and straighten any collapsed spinal structures. This process will straighten the curves associated with scoliosis.
Decompression surgery involves making space within a spine that has collapsed from spinal deformity. During this procedure, your physician will use a variety of methods, such as laminectomy or foraminotomy, to remove structures that are compressing the spine.
An osteotomy is a procedure that involves the removal of bone structures. This can entail the removal of an entire vertebra or just a section of one, in order to correct the angle at which bones sit together. This procedure is commonly used to treat scoliosis or flatback.
A physical therapist can guide individuals in strength-building exercises and loosening stretches. For some, posturing lessons may be needed to learn how to properly sit, stand, or walk. Deep tissue massage is another beneficial therapy that can complement physical therapy.