Scoliosis in North Texas

Scoliosis is a disorder that causes an abnormal curvature of the spine. Scoliosis is about two times more common in girls than boys and it can be diagnosed at any age, but it is most common in those over about ten years of age. Scoliosis is hereditary, so individuals with the condition are more likely to pass it on to their children. Dr. Kendall Carll is a board-certified spine surgeon who has more than 15 years of experience treating scoliosis. His practice, Spine Care of North Texas, has facilities in Addison and Plano which are equipped to diagnose and treat a variety of spine conditions including scoliosis. If you or your loved one has been diagnosed with scoliosis, we encourage you to schedule an appointment with Dr. Carll. Our skilled team can help you understand how to live your best life without being held back by back conditions.

In most cases, the underlying cause of scoliosis is unknown. When the cause is unknown, the condition is labeled as idiopathic scoliosis; more than 80% of people with scoliosis have idiopathic scoliosis.

Scoliosis is also labeled according to the age of the patient:

• If the patient is less than three years old, they are diagnosed with infantile idiopathic scoliosis
• Scoliosis that develops between 3 – 10 years of age is called juvenile idiopathic scoliosis
• People who are over ten years old (10 – 18 years old) have adolescent idiopathic scoliosis

There are three main subtypes of scoliosis, explained below:

• Functional: An abnormal curve has developed because of a problem somewhere else in the body. This could be caused by one leg being shorter than the other or by muscle spasms in the back.
• Neuromuscular: Either the bones of the spine fail to form completely or they fail to separate from each other during fetal development. With this type of congenital scoliosis, the patients often have other medical issues as well.
• Degenerative: Unlike the other forms of scoliosis that are found in children and teens, degenerative scoliosis occurs in older adults. It is caused by changes in the spine due to degenerative arthritis known as spondylosis. The spine can also be affected by osteoporosis, vertebral compression fractures, and disc degeneration.

The most common symptom of scoliosis is an abnormal curvature of the spine. Typically, the first person to diagnose scoliosis is a pediatrician or a health professional at a school screening. The change in the curvature of the spine typically occurs very slowly, so it is easy to miss until it becomes more apparent.

Severe cases of scoliosis can make it more difficult for the heart and lungs to work properly, causing shortness of breath and chest pain. In some situations, scoliosis can cause back pain, rib pain, neck pain, muscle spasms, and abdominal pain. However, in most cases, scoliosis is not painful.

A physical examination is usually all that is necessary for a physician to diagnose scoliosis. If Dr. Carll believes a patient has scoliosis, he will likely monitor the patient’s status for several months to see if there is any change. If upon physical examination Dr. Carll is concerned about the degree of curvature, x-rays may be recommended. Our team will take measurements from the x-rays to determine how much curvature is present. This information can help determine the best course of treatment.

Treatment of scoliosis is based on the severity of the curve and the chances of it increasing. Functional scoliosis caused by an abnormality elsewhere in the body, such as a difference in leg length, can usually be treated with a small wedge in the shoe to help even out the leg length and prevent the spine from curving. Neuromuscular scoliosis caused by an abnormal development of the bones of the spine typically requires surgical intervention. Treatment of idiopathic scoliosis usually is based on the age when it develops. In many cases, infantile idiopathic scoliosis will improve without any treatment. X-rays can be obtained and measurements compared to future visits to determine if the curve is getting worse. Bracing is not normally effective in these cases.

Juvenile idiopathic scoliosis has the highest risk of worsening over time. The goal of treatment for this condition is to prevent the curve from getting worse as the patient grows. Bracing is a key strategy for these patients.

Adolescent idiopathic scoliosis is the most common form of scoliosis. As long as the curve stays below about 20 – 25 degrees, no treatment is needed. The patient may return to Dr. Carll’s facility every 3 – 4 months to determine whether the curve has worsened. Additional x-rays may be repeated each year to obtain new measurements to chart the progression of the curvature. If the curve develops beyond 25 degrees and the patient is still growing, a brace may be recommended. Bracing is not recommended for people who have finished growing. If the curve is greater than 40 degrees, then surgery may be recommended.

Scoliosis is not typically associated with back pain. However, if back pain does occur, it may be lessened with physical therapy, massage, stretches, and exercises, including yoga. Medical treatment is mainly limited to pain relievers such as nonsteroidal anti-inflammatory medications and anti-inflammatory injections. These treatments are not, however, a cure for scoliosis and will not be able to correct the abnormal curve.

There are several different types of braces available for scoliosis. Some braces need to be worn for nearly 24 hours a day and are removed only for showering. Others can be worn only at night. The braces are used to help slow or stop the curvature from increasing. Intermittent or chronic discomfort may be a side effect of any treatment used to slow or correct the spinal curvature. Fortunately, many custom braces are fitted that they may not cause any discomfort and can be easily hidden beneath clothing. Since teenagers are more self-conscious about their appearance, custom bracing may be recommended for adolescent patients.

Dr. Carll’s goal for the surgical treatment of scoliosis is to correct and stabilize the curve of the spine and hopefully reduce any associated pain. This is achieved using a combination of screws, hooks, and rods attached to the bones of the spine. These devices are maneuvered and turned to align the spine and hold it place. The screws and rods will remain in the spine permanently. During this procedure, Dr. Carll may also perform a spinal fusion.

Surgery for scoliosis is a fairly major procedure. However, surgical techniques for the procedure have advanced considerably over the last decade to allow for a simpler recovery. Following surgery, you will be encouraged to work with a physical therapist. Typically, a young person will miss about six weeks of school and may need about six months before they are able to return to their normal activities. Recovery times can vary between individuals. Most people with scoliosis live full and productive lives with normal life expectancy and very few setbacks. Women with scoliosis can become pregnant and deliver children with no increased risk for complications, aside from the chance of pregnancy-related back pain.

Board-certified North Texas spine surgeon Dr. Kendall Carll and our entire team at Spine Care of North Texas are passionate about providing our patients with immediate and long-term relief from conditions that affect their spines. Using proven nonsurgical and surgical techniques, we strive to help patients maintain or regain their ability to enjoy life without discomfort. If you are suffering from low back pain or have been diagnosed with scoliosis, we invite you to call Spine Care of North Texas to schedule your appointment.