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.

Speaking to a 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.

  • Have you ever come across a scoliosis case like mine before?

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.

  • Will the treatment you're suggesting help me achieve the results I want?

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.

  • What can I do to improve my chances of success?

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 are my other options if I decide not to try the treatment you're recommending?

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.

 

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.

Learn More About Our Treatment Courses   Book Your Initial Scoliosis Consultation

Lordosis of the spine

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
  • Numbness
  • Tingling
  • 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:

  • 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

 

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.

Treatment Course Dates >   Book Your Consultation >

surgical procedure

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

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

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:

  • Bleeding
  • 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.

How We Can Help with Spinal Fusion Recovery >

scoliosis stress

We all experience stress in our daily lives, but for people with scoliosis, stressful and upsetting feelings are often intensified.

Today, we're going to look at the different stresses commonly faced by scoliosis patients to establish why they occur and how we can help our patients to fight them.

 

Body Image

Scoliosis can have a noticeable effect on the way your body looks. Uneven hips and shoulders are a common symptom and can leave you feeling uncomfortable in your own skin.

Many scoliosis patients are young children or teenagers (this is when idiopathic scoliosis most commonly develops), so patients often feel 'different' to their friends and peers. Children can be really cruel and are known to exploit anything that makes other children 'stand out', so bullying and teasing can be a real problem.

A lot of people with scoliosis think their curve looks much more dramatic than it actually does! But nonetheless, body image can be a real cause of stress.

How Does Scoliosis Affect Your Body Image?   Body Image Research: View Our Infographic

 

Managing Body Image Stress

If you're unhappy with the way your scoliosis makes you look, there are steps that you can take. Our exercise-based treatment courses are a great way to develop your confidence while reducing the visibility of your curve.

We use a combination of different methods (including the Schroth Method and the FITS Method) to make your body more symmetrical and to improve your posture and strength. These exercises can be repeated at home and, if practised regularly, can help to reduce body image stress.

When you visit the Scoliosis SOS Clinic, you'll meet a group of other people with scoliosis, many of whom are also struggling with their body image. Talking to these people who are going through the same thing as you (and may even look very similar to you) can really help you to manage the stress around your body image.

Book a Consultation >

 

Surgery Stress

Another stress that people with scoliosis often face is directly related to the fear of surgery. Spinal fusion is a daunting and invasive procedure, and while complications are rare, risks do exist.

Other surgery-related stresses include:

  • Missing school and events
  • How your surgery scar will look
  • Pain and the recovery process

But the stress associated with scoliosis surgery can be avoided. Many of the patients who visit our clinic choose our exercise-based therapy as an alternative to spinal fusion surgery, and they see significant improvements! We have helped scoliosis patients from all over the globe - if you want to hear some of their incredible stories, click the button below.

Scoliosis Patient Stories >

We also work with patients who have recently had spinal fusion surgery to reduce stress and speed up the recovery process. Learn more about this here.

If you have any questions about our treatment plans, or if you need help coping with scoliosis stress - reach out and get in touch! We look forward to hearing from you.

Hyperkyphosis surgery

'You need surgery' isn't something you ever want to hear. But for some individuals diagnosed with hyperkyphosis, surgery may be the only viable option to improve their condition and reduce their back pain. Non-surgical treatment methods such as physical therapy are often explored before resorting to surgery; however, if the symptoms of kyphosis are still causing problems after a certain amount of time, doctors may recommend an operation.

Other criteria that are taken into consideration include:

  • Curve progression - If the curve of the spine is getting gradually worse, doctors may suggest surgery to correct the curve and halt the progression.
  • Curve severity - In the thoracic spine (upper back), curves that exceed 80 degrees are considered severe. In the thoracolumbar spine (mid-low back), curves greater than 60-70 degrees are classed as severe.
  • Neurological symptoms - Hyperkyphosis can affect the nerves in the spinal cord as a result of spinal changes (e.g. vertebral fractures, which may cause pinched nerves). This can result in numbness, weakness and tingling feelings. In severe cases, the patient may experience bladder or bowel dysfunction.
  • Balance - Due to the spine curving forward in kyphosis, patients may have difficulty standing up straight. If a case of kyphosis results in individuals leaning forward too far, making it difficult to complete everyday tasks, surgery may be needed to rebalance the spine.

The main aims of hyperkyphosis surgery are:

  1. Decrease pain and any neurological symptoms experienced
  2. Reduce deformity
  3. Stop the curve from getting any worse

A number of different surgical procedures may be used, including:

Osteotomy

Osteotomy is a surgical procedure that involves the cutting and reshaping of bones. For individuals who have been diagnosed with hyperkyphosis, osteotomy realigns the bone ends in their spine and allows them to heal. Spinal instrumentation and fusion may then be used to stabilise the spine during the healing process.

Spinal Fusion

Once the spine has been realigned through an osteotomy, surgeons are required to stabilise and help it to heal in its new position. To do this, the surgeon will create an area where the bones in the spine fuse together over a period of time (typically several months) using a bone graft. This fusion aims to prevent movement between the vertebrae, providing more long-term stability within the spine. Based on the severity and location of the kyphosis curve, the surgeon will dictate whether the spinal fusion is performed from the front (anterior approach) or the back (posterior approach).

Balloon kyphoplasty

Kyphoplasty is a minimally-invasive treatment that's performed through a number of very small incisions. Here, a special orthopaedic balloon is placed into the compressed vertebra and then inflated in an attempt to return the vertebra to the correct height and position. The balloon creates an empty space in the vertebra which is filled with a special surgical cement. This helps to stabilise the spine.

 

Hyperkyphosis surgery risks

As with any other surgical procedure, kyphosis surgery does carry some risks that you should be aware of before you decide to go under the knife. These include:

  • Infection
  • Blood clots
  • Instrumentation becoming loose or breaking
  • Development of a secondary curve

 

Treating hyperkyphosis without surgery

If you don't like the idea of having surgery, you'll be pleased to learn that it is often possible to treat Scheuermann's disease and other forms of hyperkyphosis without any invasive procedures. Here at Scoliosis SOS, we offer world-class therapy in the form of our ScolioGold programme, which helps to straighten the back, reduce feelings of pain and improve overall quality of life.

We can also help individuals who have already undergone hyperkyphosis surgery. Our combination of proven treatment methods can help to speed up the recovery process, easing the pain experienced post-surgery, improving mobility and correcting any secondary curves that may have developed above or below the fusion.

If you would like to find out more about why our treatment courses are a great alternative to surgery, please contact Scoliosis SOS and book an initial consultation with one of our scoliosis consultants, who will more than happy to recommend the best course of action for you.

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