Scoliosis and Kyphosis

Dr. Paul, a PSSE Schroth certified scoliosis specialist, is now accepting patients with scoliosis and kyphosis.

What is Scoliosis?

Scoliosis, originating from the ancient Greek word "scolios," meaning "crookedness," is a condition characterized by an abnormal lateral curvature of the spine. This condition can either appear as a single "C" shape curve ("C" curve) or as two curves ("S" curve). Understanding scoliosis is essential, as it can significantly influence one’s posture and overall well-being.

What is Kyphosis?

Kyphosis (also known as roundback) is a spinal condition characterized by an abnormal, excessive forward curvature of the upper back (thoracic spine). This curvature can result in a rounded or "hunchback" appearance.

How is Scoliosis Diagnosed?

Dr. Anika Paul | PSSE Schroth certified scoliosis specialist
Dr. Anika Paul | PSSE Schroth certified scoliosis specialist

The journey to understanding scoliosis begins with a diagnosis. The typical ways Scoliosis is diagnosed are by:

  1. Physical Examination:
    • Adam's Forward Bend Test: The patient bends forward, and the examiner assesses for asymmetry in the back, rib cage, or shoulder blades.
    • Visual Inspection: The examiner checks for uneven shoulders, hips, or waist, or a rib cage that protrudes on one side.
  2. X-ray Imaging:
    • Posterior-Anterior (PA) Radiograph: This is the most common X-ray to diagnose scoliosis and measure the spinal curve.
    • Cobb Angle: Measuring the Cobb angle is a standard measurement used in scoliosis to quantify the degree of spinal curvature. Measuring the Cobb angle involves licensed health care providers drawing lines along the top and bottom vertebrae of the curve on X-ray imaging and then measuring the angle between those lines. If the Cobb angle is 10 degrees or more, along with notable rotational displacement of the spine, scoliosis is confirmed.

      Classifying scoliosis according to the Cobb angle is essential for developing a tailored treatment plan:

      • Mild Scoliosis: 10 to 20 degrees
      • Moderate Scoliosis: 20 to 40 degrees
      • Severe Scoliosis: 40 degrees and above
      • Very Severe Scoliosis: 80 degrees and above
    • Risser Sign: A radiographic sign used to assess skeletal maturity, which is important for determining the potential for progression of the curve.
    • Hand and Wrist X-rays: These can reveal the amount of remaining growth, which is crucial for prognosis and treatment decisions.
  3. Other Imaging (if needed):
    • CT Scans or MRIs: These imaging tests may be used to assess the underlying cause of scoliosis or to evaluate the spine in greater detail.

Recognizing these classifications not only aids in diagnosis but also facilitates the development of effective treatment strategies.

How is Kyphosis Diagnosed?

A thorough diagnosis of kyphosis begins with a detailed physical examination by your healthcare provider. As part of this evaluation, you may be asked to bend forward at the waist, allowing the provider to closely observe the curvature of your spine from the side.

To gain a comprehensive understanding of your condition, several advanced tests may be recommended:

  • X-rays or CT Scans: X-rays are crucial for accurately assessing the degree of curvature in your spine and identifying any deformities in the vertebrae. If a more detailed view is necessary, a CT scan will provide the high-resolution imaging needed for a precise diagnosis.
  • MRI: Utilizing a powerful magnetic field, an MRI can reveal any recent fractures in your spine that may contribute to your symptoms, offering critical insights for treatment.
  • Nerve Tests: If you’re experiencing troubling symptoms like numbness or muscle weakness, specialized nerve tests can evaluate the efficacy of nerve impulses traveling between your spinal cord and limbs, helping to pinpoint the source of your issues.
  • Bone Density Tests: These tests assess bone strength and density, as low-density bones can significantly increase the risk of harmful compression fractures. Importantly, this condition can often be improved with the right medications, enhancing both your safety and quality of life.

Eight Different Types of Scoliosis

Scoliosis is a diverse condition comprising several types, each with unique characteristics and impacts on individuals:

  1. Degenerative Scoliosis: Typically affecting individuals over 50, this form develops due to the natural wear and tear on the spinal joints.
  2. Neuromuscular Scoliosis: This type, which often emerges in individuals with neuromuscular disorders, profoundly affects daily life.
  3. Congenital Scoliosis: Present since birth due to abnormal vertebral formation, this often requires surgical attention.
  4. Syndromic Scoliosis: Associated with genetic syndromes such as Marfan syndrome or Down syndrome, it requires specialized care due to related health considerations.
  5. Idiopathic Scoliosis: The most common form, where the cause remains elusive, posing challenges for early detection.
  6. Juvenile Idiopathic Scoliosis: This condition typically occurs in children aged 4 to 10 and may progress during critical growth stages.
  7. Adolescent Idiopathic Scoliosis: Frequently diagnosed during puberty, presenting unique developmental challenges. Girls tend to have more severe and progressive curves than boys. However, mild spinal curvature is equally common in girls and boys.
  8. Traumatic Scoliosis: Resulting from significant spinal injuries, underscoring the urgency for prompt treatment.

Patterns and Curvatures of Scoliosis

Scoliosis can take on various patterns, each with specific implications for an individual's health:

  • Thoracic Scoliosis: The most common type, affecting the ribcage, which may lead to uneven shoulders and rib deformities.
  • Lumbar Scoliosis: This condition involves a curvature in the lower back, potentially causing imbalances in hip positioning and leg length, which can affect mobility.
  • Thoracolumbar Scoliosis: A combination of thoracic and lumbar curvatures, often present from birth, frequently associated with neuromuscular issues.

Curvatures are further categorized:

  • Dextroscoliosis: A curve towards the right side of the spine, mainly impacting the thoracic region.
  • Levoscoliosis: A leftward curvature, occurring in both the thoracic and lumbar areas.
  • Complex Curves: Such as dextroconvex and levoconvex scoliosis, which may involve additional complexities and require thorough assessments.

Structural vs. Non-Structural Scoliosis

It's essential to distinguish between structural and non-structural scoliosis to develop the most effective treatment approach:

  • Structural Scoliosis: Characterized by a permanent curve and spinal rotation; this requires careful monitoring and intervention.
  • Non-Structural Scoliosis: Often reversible and caused by external factors, emphasizing the importance of addressing underlying issues.

Meet Your Physical Therapist

Dr. Anika Paul is the founder/owner of Mettle Physical Therapy, located in Basking Ridge, NJ. She is a PSSE Schroth certified scoliosis specialist. Dr. Paul believes that one-on-one patient care, using an evidence-based approach, is vital in returning patients to their desired function. Also, what is equally important but is usually overlooked by other clinicians in the industry is to establish a maintenance and prevention protocol to avoid the reoccurrence of the injury or condition in the future.

For a deeper understanding and to explore possible treatment options, we encourage consulting with a PSSE Schroth certified scoliosis specialist, such as Dr. Anika Paul. With the right knowledge and timely intervention, those living with scoliosis and/or kyphosis can lead vibrant, fulfilling lives filled with possibility and optimism. Embracing this journey will empower you to face any challenges head-on!