The spine is made up of bones called vertebrae,
which are stacked on top of each other.
The vertebrae protect a bundle of nerve fibers
called the spinal cord.
It runs through an opening in the center of
each vertebra.
The main sections of the spine are the cervical,
thoracic, and lumbar regions.
Looking at it from the side, the spine normally
has three curves: A “C” in the cervical
spine, a reverse “C” in the thoracic spine,
and another “C” in the lumbar spine.
Viewed from behind, the spine should appear
to be completely straight up and down.
Scoliosis is a condition where the spine has
an abnormal side to side curve.
Most cases of scoliosis have no known cause.
In some cases, scoliosis may be present at
birth.
In other cases, it may occur over time—the
most common cause in adults is asymmetric
degeneration of the discs, causing the spine
to be tilted to one side or the other.
Other causes may include cerebral palsy, paralysis,
muscular dystrophy, osteoporosis, or spinal
fractures.
During childhood, the spinal curve usually
becomes worse during periods of rapid growth.
If the curve becomes severe, it can cause
problems with posture, walking, and back pain.
It can also cause the internal organs to become
cramped for space, causing heart, breathing,
and digestion problems.
Scoliosis is often treated with a brace to
stop the curve from getting worse.
Doctors will measure the spinal curve over
time to see if the brace is working.
For an adolescent, a surgical procedure may
be necessary if the brace isn’t working,
or if a brace is not an option.
For an adult with scoliosis, a surgical procedure
may be necessary if they are experiencing
numbness or weakness in their legs, or if
they are having progressively worse back pain
that does not improve with nonsurgical treatments.
The most common surgical procedure to repair
scoliosis is called posterior spinal fusion
with instrumentation and bone grafting.
To begin, the surgeon will make an opening
over the area of the curve in the spine.
The surfaces of the vertebrae will be roughened
to help stimulate the bones to heal together.
The surgeon will place screws, hooks, or wires
into the vertebrae.
Rods will be placed alongside the vertebrae
and attached to the screws, hooks, or wires
in order to straighten the spine.
The surgeon may remove small pieces of bone
from the ribs or hip bone to use as grafts.
Other times, the surgeon may choose to use
donor bone from a bone bank for grafting.
The surgeon will place the bone grafts along
the spine to allow the bone to grow together
and keep the spine stable.
At the end of the procedure, the skin incision
will be closed with stitches.
