Scoliosis Treatment Treatment Cost in India

Scoliosis is a medical condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. Mild scoliosis does not typically cause problems, but severe cases can interfere with breathing. Scoliosis does not have a complete cure, but the symptoms can be controlled and reduced with the help of treatment. This disorder causes an abnormal curve in the backbone or spine. From the side, the spine has some normal curves but then it should look straight when viewed from the front. Kyphosis is a curve found in the spine when viewed from the side where the spine is found to be bent forward.  There is a common kyphosis in the thoracic spine, or in the middle of the spine. Lordosis is once again a curve seen from the side where the backbone is found to be bent backward. Again, the cervical or upper spine and the lower or lumbar spine show normal lordosis.  Yet people with scoliosis grow an extra curve on either side of the body and the spine bones begin to twist each other, resulting in an "S" or "C" shape in the spine that causes lumbar scoliosis.

Scoliosis is found to be more common among girls compared to boys and is more common at an age group above 10. People with scoliosis tend to give birth to infants with the defect as well. But then there is no correlation between the severity of the curves from one generation to the next. Since the exact cause of scoliosis is unknown, hence it is referred to as idiopathic. The types of scoliosis are described below: 

• Infantile idiopathic scoliosis is the term used for children who are below 3 years and suffer from scoliosis
• Juvenile idiopathic scoliosis is the term used when it is found among children between the age group of 3-10 years
• Adolescent idiopathic scoliosis is the term used for patients who are in the age group of 10-18 years.

80% of the people diagnosed are affected with idiopathic scoliosis and the majority of them are young girls and the problem is usually detected in the thoracic spine. Another classification for scoliosis is given below:

• Kyphoscoliosis: where a combination of lateral and outward spine curvature exists
• Dextroscoliosis: Here the curvature of the spine exists to the right
• Levoconvex: The curvature of the spine is in the left
• Rotoscoliosis or rotatory scoliosis: the curvature found in the spine is capable of turning on its own axis
• Thoracolumbar: This curvature is related to both the thoracic and lumbar regions present in the spine

Some of the other causes of scoliosis that falls under the remaining 20% can categories scoliosis in some more types:

Functional: In this kind of scoliosis it is observed that earlier the spine is normal, but a curvature has developed over a period of time as a result of an abnormality in other parts of the body like muscle spasms experienced in the body or any one of the legs being shorter than the other one.

Neuromuscular: This kind of scoliosis is a result of a problem developed during the formation of the spine bones. Either the bones in the spine failed to form completely or they failed to segregate from each other during fetal development.  This is congenital scoliosis and will be accompanied by other disorders like birth defects, cerebral palsy, muscular dystrophy or Marfan syndrome. Infants born with this condition usually have C shaped spine with weak muscles that are unable to hold them straight. This is a very aggressive form of scoliosis and needs serious attention and treatment.

Degenerative: This kind of scoliosis is found more commonly among older adults. This condition can arise as a result of arthritis known as spondylosis.  The normal ligaments grow weak gradually and the soft tissues around the spine which are combined with abnormal spurs of bones can give rise to an abnormal curvature of the spine. The spine can also get affected by osteoporosis, disc degeneration or vertebral compression fractures.

There can be a few more causes that can give rise to scoliosis like osteoid osteoma which is a spine tumor. In fact, this is normal but will cause pain. People tend to lean to the other side of the pain and tend to lower the pressure on the tumor to avoid the pain. This leaning may cause backbone deformity. Some other factors may also play a role in causing or contributing to the development of scolioses, such as genetics, irregular fibrillin metabolism or muscle dysfunction.

The change in the curve of the spine occurs so slowly that it is easy to miss until it becomes a major physical deformity. Many may notice that clothes are not fitting properly as earlier. Some of the other symptoms of scoliosis may include tilt in the head or leaning to any one side of the rib cage or hop. When scoliosis grows more severe then rib pain, neck pain, and back pain can occur and in worse conditions, muscle spasms and abdominal pain and trouble in heart and lungs can also be observed. The patient can have shortness of breath and chest pain too.

Scoliosis treatment may require mainly a physical examination that includes looking from the front, sides, and back. The doctor will ask questions about family history and find out more. The practitioner frequently studies the body's balance to figure out more about the shoulders and hips, and any curvature downwards.

Range of motion, the strength of muscles and reflexes will also be checked since with more growth the scoliosis problem can get worse. Through a series of X-rays spread out in a certain time window, the doctor can understand towards which side the curvature is advancing with further body growth. Depending upon that, treatment options are explored. Not only X-rays of the spine, but also of pelvis, hand or wrist and legs can be done to contemplate the growth potential of the patient.

The own bone is usually considered an excellent option for scoliosis surgery. But some surgeons now use allograft bone instead. The main reason behind selecting allografts is to avoid pain in the donor site which troubles the patient for a long time. (the part of the body from where the patient's own bone is taken to repair the problem). There can be other problems of infection, fracture, nerve irritation and bleeding as well.

In spinal fusion, there are many kinds of bone graft used from the patients’ bodies. Like extra bone scooped out from the iliac crest of the hip and can be used as a bone graft.

Allograft bone is taken from a deceased donor and it can cause an extensive sterilizing or cleaning process before it is used on any other patient. To improve the bone fusion capability of the allograft bone, it is mixed with the marrow.

Apart from the above, bone surgeons are also making use of synthetic materials to allow the spine to fuse. These products can be combined with the patient’s bone or even allograft ones. They work like a framework to permit the new bone to form and mature or chemically initiate the formation of new bone. Bone morphogenetic protein or BMP is a product that is commonly employed in spine surgery among adults and it is recommended to aid in the formation of bone.

The kind of bone graft that is used, depends on various factors and most surgeons choose as per their experience and convenience. In very rare cases, in the team of surgeons, a neurosurgeon may also be involved in the spinal fusion since certain nerves may be involved in the medical condition.

If osteoid osteoma or the tumor is causing scoliosis, then a surgery involving the removal of the tumor in surgery is enough to cure the problem.

The rods that are used as implants are made of cobalt-chromium, stainless steel and titanium and they are capable of breaking. A broken rod is an indication that the spine is not fused totally and will require another surgery since they are under stress due to a lack of a solid fusion.

The time to recover from surgery and the formation of scar tissues vary from one person to another. Medication may be prescribed by the doctor for pain management. The patient is expected to be out of bed and on the chair right after the first day of the surgery and will work with a physical therapist who can actually assist in walking. Over a period of time stress will be laid on recovering muscle strength. Youngsters may require skipping schools for 6 weeks after the surgery and will take almost 6 months to lead a normal life, but this time period will vary from one person to another.

Apart from this, the patient must be monitored for any infection complication or subsequent nerve damage or spinal cord damage during the surgery and the progression of the curve.

Apart from surgeries, there are many other ways in which scoliosis can be treated. There are different kinds of braces that are used to stop the growth of the curve or slow it down. It will not be possible for braces to correct the existing curvature.

Different methodologies are used for slowing or correcting the curve, but if the curve is more than 40 degrees, then it is expected to increase by 1 or 2 degrees by every year and then surgery may be considered. 

Besides these, intake of physical therapy or specific diet or supplements such as L-selenomethionine can also help in the medical condition. Many doctors also consider using a special pillow, which can be changed to minimize pain as a treatment for scoliosis.