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Spine Deformities – Diagnosis, Treatment and Prevention

The human spine is made of small bones called vertebrae, which are stacked together with discs, one on top of the other. A healthy spine will have a gentle curve when looked from the side, which is quite natural. In fact, the curve of the spine helps it to absorb stress and shock from gravity and body movement.

The spine should run straight down the middle of the back and if there are any abnormalities, it will get misaligned at some areas. This condition is called spine curvature disorder and can be broadly classified into Lordosis, Kyphosis, and Scoliosis.

  • Scoliosis describes a condition in which the spinal column curves sideways, moving toward an S-shape or a C-shape. This is perhaps the most common type of curvature. Scoliosis can happen to anyone, but it occurs most often in children as they develop.
  • Lordosis describes an exaggerated inward curve in the lower back (also known as “swayback”), often characterized by protruding buttocks.
  • Kyphosis is characterized by an exaggerated outward curve (or “rounding”) of the upper back, causing the head to shift forward as well as a “hunchback” appearance.

Tests and Diagnosis

To establish the existence and extent of spinal deformity, the following tests may be advised:

  • X-ray (also known as plain films) –test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones. Soft tissue structures such as the spinal cord, spinal nerves, the disc and ligaments are usually not seen on X-rays, nor on most tumors, vascular malformations, or cysts. X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column. Spinal dislocation or slippage (also known as spondylolisthesis), kyphosis, scoliosis as well as local and overall spine balance can be assessed with X-rays. Specific bony abnormalities such as bone spurs, disc space narrowing, vertebral body fracture, collapse or erosion can also be identified on plain film X-rays. Dynamic, or flexion/extension X-rays (X-rays that show the spine in motion) may be obtained to see if there is any abnormal or excessive movement or instability in the spine at the affected levels.
  • Magnetic resonance (MR) imaging: uses a magnet and radio waves to provide detailed images of the spine as well as the spinal cord, the spinal nerves, and other soft tissues
  • Computed tomography (CT) scan: a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of bones and soft tissues. CT scans are more detailed than general X-rays.

Treatment and Prevention

Kyphosis

The treatment of kyphosis chiefly depends on the cause and the severity of the condition. Following treatment modalities are available:

  • Pain relieving medications- Prescription medications can be administered in cases where the pain cannot be managed by the regular over-the-counter medicines (such as ibuprofen, acetaminophen, and naproxen sodium).
  • Bone-strengthening medications- Medications are prescribed for treating osteoporosis in order to prevent spinal fractures in future.
  • Exercise- Stretching exercises are advised by a physical therapist to reduce a backache and improve spinal flexibility.
  • Bracing- In certain cases, bracing can help in impeding the progression of kyphosis. For instance, wearing a body brace during the growth period might help the children who have Scheuermann’s disease.
  • Surgical intervention: In severe cases, surgeries might be required to rectify the position of the spine.

Scoliosis

The treatment depends on the age of the patient and the severity of the condition. In mild cases, no treatment or surgery is required. However, in moderate to severe cases, the following treatment options may be considered:

  • Scoliosis brace: It helps children during their growth years. It does not treat or reverse scoliosis but prevents its progression.
  • Surgical intervention: Surgeries such as spinal fusion may be executed in order to reduce the severity of the condition and prevent worsening. Surgery might have complications such as nerve damage, bleeding, pain, infection etc.

Lordosis

  • Medications: Medications are usually prescribed to control inflammation and pain.
  • Physical therapy and exercise: This helps to augment muscle strength and flexibility.
  • Back brace: This can help to support the spine.
  • Surgical intervention: Corrective surgeries are performed in few cases.

Weight-loss is advised in case of obese patients to reduce the stress on the spine. Prevention is mainly by maintaining a right posture and use of protective gears during driving, playing sports, cycling etc. in order to prevent accidents and trauma. Early intervention can prevent the progression of the condition.

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