Although there is no cause for the curvature of the spine in that majority of cases we treat here at Scoliosis SOS, and in scoliosis patients in general, there are several medical conditions which can lead to the development of scoliosis.
Today, we are focusing on one of the conditions which can lead to the development of scoliosis, namely, Guillain-Barré Syndrome. Many will not have heard of the condition previously, due to its rare and serious nature. It occurs when the immune system attacks part of the nervous system, and is often the result of a viral or bacterial infection.
One of the primary symptoms of Guillain-Barré is progressive muscle weakness, and a resulting loss in coordination. Although many sufferers of Guillain-Barré go on to recover from their condition, a lasting impact is often caused by this weakening of the muscles, which in some cases, can lead to the development of scoliosis.
Such was the case for our previous patient Jonathan, who suffered with Guillain-Barré for a year, and was diagnosed with scoliosis shortly afterwards. Upon initial diagnosis, Jonathan was told he had a 19° curve and was given a corrective brace, but six months later he was told that this had progressed to a 38° curve.
Improved muscle strength and coordination are a huge part of our treatment process here at Scoliosis SOS, targeted by the inclusion of methods such as the PNF Technique, along with other elements of our ScolioGold programme. For this reason, our treatment approach can be incredibly beneficial for an individual who has been left weakened by the impact of Guillian-Barré, as is exemplified in Jonathan’s treatment video below:
If you would like to learn more about how we can aid the recovery of Guillian-Barre sufferers, and relieve symptoms of their scoliosis, please get in touch by calling 0207 488 4428, or by filling out our enquiry form here.
From lung cancer to cardiovascular issues, the health risks associated with smoking are well documented. One of the many reasons to quit smoking is the fact that it can cause spinal degeneration and severe back pain, which in turn can lead to a form of scoliosis known as de novo scoliosis.
In a nutshell, de novo scoliosis is a spinal curvature that develops in adulthood as a result of spinal degeneration. In some cases, a curvature of the spine occurs as a result of the facet joints and discs in the lumbar (lower) spine ageing, leading to the vertebrae slipping out of place and the spine losing its shape.
But if this degeneration occurs as a result of ageing, what does smoking have to do with it?
Smoking and degenerative discs
Although ageing and genetic predisposition are the main risk factors for degenerative discs, a growing number of studies indicate that smoking is another leading risk factor in the deterioration of both lumbar discs and cervical discs (found in the neck). Nicotine has been shown to deprive disc cells of vital nutrients as a result of small blood vessels becoming constricted. In addition to nicotine, through smoking, you introduce carbon monoxide into the bloodstream and your body’s tissues. These poisons begin to inhibit the disc’s ability to absorb the nutrients it needs, which can result in prematurely dehydrated and less pliable discs.
As the discs in the spine become more malnourished, there is a greater risk of a rupture occurring. This happens when the disc’s contents break through the outer layer of the disc, often encroaching on nerves and causing severe pain and discomfort. These same poisons also interfere with calcium intake, leading to a compromised spinal structure and – potentially – scoliosis.
Other risks related to smoking and scoliosis include:
- Coughing – This is much more prevalent among smokers and can increase the risk of degeneration in the discs. Coughing causes increased pressure between discs, which puts added strain on both the spine and discs, resulting in a greater risk of ruptures and bulges. This is particularly common in a spine that’s already been weakened by smoking-related toxins.
- Inactivity – This is often associated with a smoker’s lifestyle, and can result in a higher frequency of back pain. Unfortunately, pain caused as a result of degenerated discs can make an active lifestyle even more difficult to adopt and enjoy.
Smoking and failed spinal fusion
Spinal fusion surgery is often recommended for severe cases of scoliosis. The procedure involves using a bone graft to fuse vertebrae together. The long-term success of this procedure is dependent upon successful fusion; in fact, if the fusion does not heal correctly, surgery may have to be repeated.
Many different factors can have an impact on the success of spinal fusion, including age, underlying medical conditions and – yes – cigarette smoking. Smoking disrupts the normal functions of basic body systems that contribute to bone formation and growth, which are imperative for a fusion to heal properly.
Studies have shown that habitual cigarette smoking leads to the breakdown of the spine to such a degree that fusion is often less successful when compared to similar procedures performed on non-smokers. Smoking can also have a huge impact on the immune system and the body’s other defence mechanisms, which in turn can lead to an increased risk of post-operative infection.
Treatment at the Scoliosis SOS Clinic
If you’ve been diagnosed with de novo scoliosis and wish to avoid surgery, we at the Scoliosis SOS Clinic can provide effective exercise-based treatment that aims to correct your condition. Our ScolioGold treatment programme is designed to improve mobility, boost strength and correct abnormal posture, combining a variety of proven non-surgical techniques to achieve noticeable, lasting results.
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Whether you’re taking your child to see a GP or an orthopaedic specialist, you’re going to have a lot of questions about scoliosis and the available treatment options. In this blog post, we’ll talk you through a range of scoliosis questions that you may wish to ask your doctor.
If you’ve just been diagnosed with scoliosis, there are a number of questions you can ask your doctor to help you gauge whether they’re offering you the right treatment plan. It’s important to ascertain their knowledge and experience with this condition before you go any further.
Not every GP will have an extensive understanding of scoliosis, particularly if they’ve never dealt with a spinal curve like yours before. If that’s the case, the GP might not be able to offer you the responses to your questions that a scoliosis specialist could.
Questions to Ask Your GP
Always be respectful towards your doctor, even if you decide not to pursue treatment with them. Try not to get upset or angry if you don’t agree with their assessment of your condition.
Every case of scoliosis is different, so it’s possible that your GP hasn’t treated a case of scoliosis like yours before. Doctors who’ve been working with scoliosis for many years may have patient testimonials and evidence to show that the treatment approach they’re suggesting works for cases like yours.
- Have you ever come across a scoliosis case like mine before?
Each scoliosis patient has different expectations. Some people are most concerned with their appearance while others want to improve their mobility or flexibility. The treatment option that will help you achieve your desired results might not be the one that your doctor is prescribing. For example, a scoliosis brace can help to prevent your scoliosis curvature from getting worse, but if your main concern is your appearance, you might not want to wear a scoliosis brace all the time.
- Will the treatment you’re suggesting help me achieve the results I want?
With more active approaches to treatment, you might be able to improve your results by following a particular regime or plan accurately, or by doing extra activities at home to improve the effectiveness of your treatment. That’s certainly the case with our exercise-based therapy programme, which should be continued at home once you’ve left the clinic.
- What can I do to improve my chances of success?
If you’re nearing the end of your consultation and you’re not happy with how it’s going, it’s completely natural to wonder what your other options are. If your doctor has no other types of treatment for you to choose from, this could be a red flag. Even if the doctor genuinely doesn’t have any other treatment options lined up for you, they should be able to refer you to another doctor who can provide additional support and advice.
- What are my other options if I decide not to try the treatment you’re recommending?
Seeking Specialist Help
If you feel like you’ve exhausted your doctor’s knowledge and haven’t got the answer you wanted, it might be time to look elsewhere. Doctors are great, but when it comes to complex conditions like scoliosis, you could be better off speaking to a specialist.
Here at the Scoliosis SOS Clinic, we’ll invite you to attend an hour-long initial scoliosis assessment with one of our specialist consultants. We can even conduct your initial consultation over the phone or via Skype if you have photos and/or X-rays of your back already.
Before recommending a treatment path, we take 2 measurements of your back: one to assess the rotation or kyphosis/forward bend in your spine, and a second photographic scan of your spine that analyses your back shape and profile. Then we’ll summarise our diagnosis, explain our proposed treatment plan and give you an idea of therapy timescales, plus the type of results you can expect to achieve.
Even if you attend one of our consultations, you’ll be under no obligation to pursue treatment with us. We want you to be empowered to make a choice about your spinal treatment and ultimately do what’s best for you.
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What is lumbar lordosis?
Lumbar lordosis is the normal inward curvature of the spine, located in the lumbar (lower) region of the back. This curve helps the body to absorb shock and remain stable yet flexible. If the curve arches too far inward, however, it’s known as increased lumbar lordosis – or hyperlordosis.
In extreme cases, there will be a visible C-shaped arch from the lateral view when the diagnosed individual stands, resulting in their abdomen and buttocks sticking out. This postural position can also be associated with an increased thoracic kyphosis, often resulting in excess pressure on the spine, causing pain and discomfort.
Causes of lumbar lordosis
Lordosis of the spine can be caused by several conditions and factors, affecting people of any age. These include:
- Spondylolisthesis – This is a spinal condition where one of the lower vertebrae slips forward onto the bone below. Learn more about spondylolisthesis here.
- Achondroplasia – This is one of the most common types of dwarfism.
- Osteoporosis – This is a bone disease that leads to decreased bone density, increasing the likelihood of the risk of fractures.
- Obesity – Obesity is an epidemic in a number of countries all around the world. This condition puts people at a higher risk of developing serious diseases such as type 2 diabetes and cancer.
- Osteosarcoma – This is a bone cancer that typically develops in the shinbone near the knee, the thighbone or the upper arm near the shoulder.
Symptoms of lumbar lordosis
The most common symptom of lumbar lordosis is muscle pain. When your spine begins to curve abnormally, your muscles get pulled in multiple directions, causing them to spasm or tighten, which can limit movement in your lower back.
To check if you have hyperlordosis, simply lie on a flat surface and check to see if there is a lot of space between the curve of your back and the floor. If you can easily slide your hand through the space, you may have lumbar lordosis. Other symptoms include:
- Weakness of the spine
- Weak bladder control
- Difficulty maintaining muscle control
Lumbar lordosis in children
Often, lumbar lordosis appears during childhood without any apparent cause. This is known as benign juvenile lordosis and occurs as a result of the muscles around the hips weakening or tightening up. Benign juvenile lordosis isn’t usually too much of a concern, however, as it tends to correct itself as children grow up.
Other conditions that can cause lumbar lordosis in children are often related to the nervous system and muscle problems. Examples include:
- Cerebral palsy
- Spinal muscular atrophy – An inherited disorder that causes involuntary movements
- Muscular dystrophy – A group of inherited disorders that result in muscle weakness
- Myelomeningocele – An inherited condition where the spinal cord sticks through a gap in the bones of the back
- Arthrogryposis – An issue that occurs at birth where the joints are limited in movement
How is excessive lumbar lordosis diagnosed?
To determine if you have hyperlordosis, your doctor will examine your medical history, conduct a physical assessment and ask about other symptoms. During the physical assessment, your doctor will ask you to bend forward and to the side. Here, they are checking whether the curve is flexible or not, whether your spine is aligned correctly, your range of motion and if there are any abnormalities. They may also ask several questions regarding your spine, its curve and your symptoms.
After narrowing down the possible causes of your lumbar lordosis, your doctor will order tests, including X-rays, in order to determine the angle of your lordotic curve. This will help to diagnose lumbar lordosis based on the angle in comparison to other physical features like height, body mass and age.
Lumbar lordosis treatment
Unless your case of lumbar hyperlordosis is severe, you will not require any treatment. However, if your condition is severe, there are a number of treatment options available to you. These include:
Here at the Scoliosis SOS Clinic, we provide non-surgical, therapy-based treatment programmes to help improve a variety of spinal conditions, including lumbar hyperlordosis. Our team of expert therapists help patients to perform a variety of exercises aimed at increasing the strength and range of motion of the muscles in the back. You can learn all about our award-winning ScolioGold treatment here.
If you would like more information on our therapy-based treatment courses, please do not hesitate to get in touch today.
- Medication to minimise pain and swelling
- Physical therapy to strengthen muscles and increase range of motion
- Wearing a brace to correct the curvature
- Surgery for the most severe cases
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For many individuals diagnosed with severe cases of scoliosis, the only available treatment option is spinal fusion surgery. This, of course, can be quite daunting and worrying, especially if the patient is young or has never undergone any sort of surgical procedure before.
The bone graft applied during spinal fusion surgery causes the bones in the spine to fuse together over a period of time. This fusion aims to stop movement between the vertebrae, providing long-term stability within the spine.
Spinal fusion has just a 2-3% risk of complications; however, as with any other surgical procedure, problems do occasionally arise once the operation is complete. If you’re thinking of undergoing spinal fusion surgery for your scoliosis and would like to know more about possible long-term side effects, here are some of the things you may potentially experience.
Failed Back Surgery Syndrome (FBSS)
One of the most common problems encountered after spinal fusion surgery – or any type of surgery involving the back – is failed back surgery syndrome. This is a misnomer; FBSS is not actually a ‘syndrome’ but a very generalised term that is often used to describe the condition of patients who have not had a successful result with spinal or back surgery and have experienced continued pain post-surgery.
Surgeons are not able to physically ‘cut out’ the pain felt by patients. They are only able to alter the patient’s anatomy. In most cases, the number one reason why back and spinal surgeries are not effective (and have to be repeated) is because the area that was operated on was not actually the cause of the patient’s pain.
Pseudarthrosis of the spine can result from a failed spinal fusion and may occur at any place where spinal fusion was attempted. It presents itself as either a pain in the neck or back (axial) area or radical (arm and leg) pain that occurs months or years after a previous spinal fusion.
During spinal fusion surgery, if the bones do not fuse together properly through the bone graft, then motion may continue across that area. For some individuals, the motion can cause pain similar to that of a broken bone that never heals.
Patients with metabolic disorders such as diabetes are at increased risk for the development of pseudarthrosis. Smoking is a common risk factor. Some surgeons may even refuse to operate on smokers as it poses such a great risk for failed fusion. Other factors of failure include obesity, chronic steroid use, osteoporosis and malnutrition.
The choice and use of fusion material, number of fusion levels, surgical technique and instrumentation have also all been shown to influence the rate of success and impact quality of life after spinal fusion.
Infection is another problem that can sometimes occur after spinal fusion surgery. Infections can be classified by the anatomical location involved: either the vertebral column, the spinal canal, intervertebral disc space or the adjacent soft tissues. Infection may occur as a result of bacteria or fungal organisms; most post-surgery infections occur between three days and three months after the operation.
Vertebral osteomyelitis is the most common form of spinal infection, developing from direct open spinal trauma, infections in surrounding areas, and from bacteria that spreads from the blood to the vertebrae.
Other common problems that can occur as a result of spinal fusion surgery are:
- Anaesthetic complications
- Paralysis (very rare)
Alternatives to spinal fusion surgery
Here at Scoliosis SOS, we have had success in treating patients who have been diagnosed with severe scoliosis (40-50 degrees and over) with our non-surgical, exercise-based ScolioGold programme. If you’re worried about some of the potential long-term side effects of spinal fusion surgery, and you’d like to try non-surgical treatment first, be sure to get in touch with us.
Spinal fusion recovery
If, however, you have already undergone surgery but are still experiencing some pain, our physical therapy programme can still help you.
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