Spine Deformities Treatment in Latur

Spine deformity is a medical term that refers to an abnormal curvature or arching of your spine or vertebral column. It is believed your spine is S-shaped, providing excellent support and balance to the body while offering shock absorption to distribute the forces evenly. An abnormal curvature can occur as a birth defect (congenital) or due to aging, injury, infections, poor posture, and inflammation of the joints (arthritis). Spine deformities present with a visible misalignment of the spine, pain, numbness, weakness of the legs or arms, and loss of sensation in the extremities. Treatment includes medications, bracing, physical therapy, steroid injections, or surgery.

Spine deformities are defined as an unnatural curvature of your spine that differs from the normal S-shaped arch. A normal spine varies in size and shape and usually curves towards the front and back of your body. This curvature is normal to balance your body and maintain an even distribution of forces throughout your body. A spine deformity usually occurs when your spine varies beyond 10° from the normally healthy, S-shaped curvature. Spinal deformities can range in seriousness from mild to moderate or severe.

The major types of spinal deformities include:

Scoliosis

This is an abnormal side-to-side arch in your spine, which can curve towards your left (levoscoliosis) or right (dextroscoliosis). It is commonly seen in young children, adolescents, and adults. There are several types of scoliosis, namely,

• Infantile scoliosis: Occurs in children less than 3 years of age, with other congenital and neurodegenerative conditions like cerebral palsy, etc. Non-surgical treatments are used to allow the proper growth of the spine.
• Juvenile scoliosis: Occurs in children between 3 to 10 years of age. Bracing is often used as an initial treatment for surgical correction until the children reach their age and body size.
• Adolescent idiopathic scoliosis: Most common in the age group of 10 to 17 years. Treatment depends on the severity of the curvature and symptoms present. 
• Adult degenerative scoliosis: It is a common form of scoliosis seen in adult life, along with the onset of degenerative arthritis. It is often associated with nerve compression and spinal stenosis (spinal canal narrowing).
• Kyphosis: This type of spine deformity occurs when the upper back develops a forward hump, commonly called a hunchback. 
• Lordosis: It is a spine deformity in which there is an inward curve in your lower back that leads to abnormal bulging of your abdomen and causes the pelvis to curve back and out.
• Flatback syndrome: This condition develops when the spine loses its natural curve and appears straight or flat.
• Ankylosing spondylitis: It is a form of arthritis that causes the vertebrae to fuse together. Your spine loses its mobility, and your posture gets locked into one position. 
• Spondylolisthesis: This is also known as a slipped vertebra caused by a birth defect.

Your spine can be abnormally curved and deformed due to several reasons (seen among both children and adults) that include the following:

Congenital

• Present by birth due to gene malfunction that regulates spine development in the embryo.
• It is the most common cause of spinal deformities seen in young children and adolescents.

Inflammation of the joint

• Arthritis can cause gradual wear and tear of the vertebral column (spine).
• This can occur as an aging process. 

Trauma

• Accidents and falls can result in spinal fractures that can alter the normal curvature of your spine.

Infections

• Certain infections like spinal tuberculosis can destroy the boncurvature's bone structure pushing the vertebrae out of alignment.

Neuromuscular diseases

• Muscular dystrophy can lead to weakness of the muscles that support the spine.

Osteoporosis

• It is a condition that decreases the bone mineral density and mass that alters the bone strength making it more prone to fractures. 
• It leads to vertebral collapse and hunchback.

Poor posture

• This is often due to improper body mechanics during heavy weight lifting, which can displace the spinal disc. 

With various causes leading to spinal deformities, the symptoms can vary significantly depending on the type and severity of the spinal deformity present.

Symptoms in children and adolescents:

• A visible curve in the spine (an alteration in the normal S-shaped curve of the spine)
• Uneven shoulder heights (due to poor posture)
• Tilted pelvis (as seen in lordosis due to poor postural habits)
• Hunchback (forward curve of the upper back as seen in kyphosis)
• The head is not centered with the rest of the body (due to curvature in the cervical/neck part of the spine)
• Uneven hips with an altered waistline (due to an abnormal inward spinal curve at the lower back)
• Breathing difficulties (scoliosis can cause severe anatomical distortion of the chest)
• Walking difficulties (as seen in lordosis)
• Back pain (due to upper back curving forward, forming a hump)

Additional symptoms in adults (along with other symptoms as seen in children)

• Radiating pain that shoots into your arms, legs, and feet (pain can be dull, nagging, or sharp in nature)
• Herniated disc (bulging of the disc through micro tears in the outer layer of the spinal disc)
• Pinched nerves or spinal cord compression (the median nerve can be compressed, causing pain and tingling sensation)
• Heart, lung, or bladder complications (an abnormal curvature as seen in scoliosis can exert pressure on your heart, lungs or bladder)

Your doctor can diagnose a spinal deformity if you or your child is suffering from it and determine the severity of the condition to plan out a treatment protocol. 

Medical history

During the initial visit, your doctor will take your medical history to:

• Evaluate your symptoms like neck or back pain, breathing, walking difficulties, etc. 
• Rule out other possible medical conditions like arthritis, diabetes (increased blood sugar levels), hypertension (high blood pressure), or the presence of any birth defect (in your child).
• To assess your social history (in adults), like smoking and alcohol consumption, may increase your risk of spinal degeneration.
• Note the medications, including blood thinners, anti-inflammatory drugs, antidepressants, or any vitamin supplements that you are on presently.
• To check for any history of previous surgery, injury, or accident that may have altered the spinal curvature.

Physical exam

• Your doctor will physically evaluate your neck, shoulders, back, and hips to check for swelling or tenderness.
• A visible misalignment can easily be detected through the naked eye or X-ray images.
• Your gait (your manner of walking) will be assessed to check for any walking difficulties.
• Your doctor will also examine your arms, hands, legs, and feet for any numbness or tingling sensation.

Diagnostic tests

These are recommended by your doctor to get a clear picture of the type or extent of the spinal abnormalities. These include:

• X-rays
  • X-rays of the vertebral column may reveal fractures, degeneration, arthritis, or slippage of the vertebrae.
  • Dynamic X-rays (taken when the spine is in motion) can easily detect spinal instability in the affected areas. 
• CT (Computed Tomography) scan
  • It is a scan that provides 2D (two-dimensional) images of your spine. 
• MRI (Magnetic Resonance Imaging)
  • It helps identify abnormalities of the soft tissues, including tendons, ligaments, and spine muscles. 
• Bone density test
  • It determines the strength of your vertebrae and detects any bone loss.
• Myelogram
  • It is a specialized X-ray that uses a contrast dye in the spinal canal to view the spinal cord and the nerves.
  • This can detect nerve compression, bony overgrowths, or stenosis.

After a thorough physical examination and accurate diagnosis, your doctor will advise treatment according to the severity of the condition. 

Mild to moderate spinal deformities can be treated with non-surgical conservative methods, while severe cases need surgical intervention. 

Non-surgical treatment

Medication

• Pain in your neck or back can be effectively managed through painkillers prescribed by your doctor. 
• Anti-inflammatory drugs help reduce inflammation caused by the constant wear and tear of the spinal joints.
• Oral steroids or injections relieve pain, swelling, and nerve compression.

Physical therapy

• Your physical therapist can help you with exercises that strengthen the muscles around your spine. 
• These exercises help improve flexibility, range of motion, and balance provided by the spine.
• These include neck and back stretching exercises, yoga, walking, pelvic tilts, arm and leg raises, etc. 

Bracing

• This is the most effective treatment for children with scoliosis that encourages proper spine growth.
• Adults do not benefit much from braces since their spines have matured, and the deformity cannot be corrected through bracing.

Surgical treatment

The surgery aims to stabilize the spine at the area of the deformity. A neurosurgeon (a surgeon who treats spinal defects and disorders) or an orthopedic surgeon (a doctor specializing in the diseases of bones and joints) performs various surgeries.

• Posterior Spinal Fusion
  • Here tiny pieces of bones (bone grafts) are added to the spaces near the affected area, which fuse together and heal. 
  • Metal rods, screws, and plates are used to secure the bone grafts to keep the spine in place for proper fusion. 
• Anterior Fusion 
  • The procedure involved is the same as the posterior fusion, but the incision is placed in front of the body near the ribs.
  • The surgeon will navigate through the abdomen to access the spine to fuse the vertebrae. 
• Spinal Osteotomy
  • This surgical procedure involves cutting off a section of the spinal bone, which is removed to allow correction of the spinal alignment.
• Decompression surgery
  • Discectomy- A part of the spinal disc is removed to reduce the pressure exerted over the spinal nerve.
  • Laminotomy or Laminectomy- Your surgeon will remove either a piece or all of the bony arches on your spinal canal to expand the canal and relieve pressure.

Though congenital spinal deformities cannot be cured or prevented, other preventive measures lower the risk of developing the condition:

• Exercising regularly should include strength training to maintain optimal bone health and muscle mass.
• Taking calcium or vitamin D supplements, especially to avoid osteoporosis.
• Avoiding contact sports or other high-impact activities that may increase your risk of back or neck injury. 
• Using good body mechanics while working out, sitting, lifting or standing. 
• Avoiding unhealthy social habits like smoking and alcohol consumption.
• To maintain a healthy bone structure, consume a well-balanced, nutritious diet (fruits, vegetables, whole grains, eggs, fish, meat, etc)

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