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Spinal deformity is an abnormal alignment or curve of the bony vertebral column. It occurs when the spine varies by more than 10 degrees from the natural curvature. When viewed from the side, a normal spine stands upright and has a natural curve that resembles the shape of the letter ‘S’. Looking at an individual from the front or back, the spine should appear straight, with symmetrical shoulders and a level pelvis.
The spine is a column of 33 bones known as vertebrae, each stacked on top of another. Each of the vertebrae is connected by ligaments. Other parts of the spine include:
Spinal cord: The spinal cord is a fragile, tubelike long structure that starts at the end of the brain stem and runs down almost to the bottom of the spine.
Nerves: Nerve roots branch out from the spinal cord through openings in the vertebrae and transport messages between the brain and the other organs of the body.
Intervertebral discs: These are the flexible discs present between the vertebrae. These act as shock absorbers and give flexibility to the spine.
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The major types of spinal deformities include:
Scoliosis: Scoliosis is the most common type of Spinal Deformity. It refers to a sideways curvature of the spine that occurs most often during the growth spurt just before puberty.
Kyphosis: Kyphosis is characterized by a rounded upper back that looks abnormal. In this condition, the shoulders round forward, the head juts out, and the torso appears to slouch.
Lordosis: Lordosis or swayback occurs as a side effect of Kyphosis. The spine of a patient with significant lordosis curves significantly inward at the lower back.
Flatback Syndrome: Flatback syndrome develops when the spine loses its natural curvature. Patients suffering from this syndrome suffer difficulty in standing up straight and appear stooped forward.
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The most common causes of spinal deformities are as follows:
Some spinal deformities result from congenital disabilities. Genetic defects such as fused vertebral segments or incomplete formation of vertebral segments also cause spinal deformities.
Poor posture in critical periods of spinal growth can cause the upper back to round forward. Other poor postures, including poor body mechanics when lifting, can also result in displaced vertebrae or ruptured discs.
Disorders like cerebral palsy can alter muscle activity. The pull by stiff muscles on the spine can cause the neck and back to lose their natural curvature.
Infectious diseases such as spinal tuberculosis destroy the bones and other structures of the spine. Inflammatory diseases such as arthritis can cause bone spurs to develop and push the vertebrae out of alignment.
Wear and tear on the spine can cause discs in your back to degenerate.
Accidents like falls, or injuries like a sudden blow to the back, can alter the curvature of your back by causing fractures or dislocations.
The most common type of symptoms of any spinal deformities are as follows:
After studying the patient’s general health and medical history, a physical examination is performed to assess muscle strength and sensation in the legs and arms.
Imaging studies:
After the physical test of the patient, the following are some imaging tests performed to diagnose spinal deformity:
Electromyography (EMG) / Nerve Conduction Studies (NCS):
EMG measures the electrical impulses of the muscles at rest and during contractions. EMG studies are often performed along with nerve conduction to determine if the nerve is functioning properly.
The non-surgical and surgical methods available for spinal deformities treatment are given below:
Anti-inflammatory drugs, such as ibuprofen or diclofenac, can be used to reduce pain. Sometimes simple analgesics such as paracetamol can also control pain. Steroids, epidural steroid injections, and facet injections are also helpful in select patients.
The most popular physical therapies for scoliosis include Schroth physiotherapy. Other strengthening exercises can help those with excessive kyphosis, for example.
Bracing can be used for slowing or halting the progression of a spinal curve. Wearing a brace is generally used for childhood scoliosis, as it remains ineffective when it comes to straightening an adult’s spine.
When a spinal deformity reaches a certain degree, surgery may be required in order to prevent the curve from progressing further. Surgery for a spinal deformity is typically a complex procedure and will require a detailed understanding by the patient and their family prior to its undertaking. A discussion around the aim, the benefits and the potential risks/complications will be had with Dr Sherief. Feel free to ask as many questions as you like. Surgery aims to fuse the spine but not necessarily fully straighten it.
Dr Sherief is one of the most renowned surgeons for spinal deformities treatment in Dubai. He has a great specialization in all kinds of spinal treatments. Not only does he have a great clinical success record, but he is also one of the very few surgeons worldwide trained in the use of robot-assisted surgeries. His patients’ reviews are the testimonials of his caring, confidential and discreet approach to them.
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