What is scoliosis?
Scoliosis is abnormal side to side curvature and rotation of the spine. It may be in the shape of an S or a C. It is a complex 3D deformity of the spine that creates the perception of asymmetry of the shoulders, waist, or rib cage. It affects 2-3% of the population.
There are two predominant types: degenerative scoliosis and idiopathic scoliosis.
- Idiopathic scoliosis is the most common spinal deformity that develops in healthy children. It is often discovered during periods of rapid growth in girls from age 9-14 and in boys 11-16. This disorder runs in families. In 80% of cases the cause is unknown. Adolescent scoliosis is often discovered in adulthood because scoliosis in childhood may cause no symptoms until it progresses and the patient ages.
- Degenerative scoliosis is a sideways curvature of the spine caused by degeneration of the spinal discs and vertebrae. It may be related to arthritis or osteoporosis. Degenerative scoliosis is often found in the lumbar spine. Symptoms are like those found in degenerative disc disease and spinal stenosis including sciatica, low back pain, leg pain, tingling and numbness.
What are the symptoms of degenerative scoliosis?
- uneven alignment of the pelvis and hips
- loss of height
- muscle weakness
- difficulty standing upright
- leg numbness and weakness
How is scoliosis diagnosed?
Dr. Girardi will review the patient’s medical and family history and ask about pain and symptoms. He will conduct a complete examination of the back and perform various tests to evaluate the patient’s nerves and motor function. He will order full spine X-rays, and a CT scan to confirm a diagnosis. An MRI may be obtained to provide information about the discs, nerves, and soft tissues; and reveal associated conditions including spial stenosis and degenerative disc disease. The severity of the curvature is determined by measuring the degree of curvature.
What are the treatments for scoliosis?
Treatment options are based on the location and severity of the symptoms and the underlying cause of the curvature. All treatment decisions are made on a case-by-case basis. The goal is pain relief, restoration of stability, and reduced disability.
The mainstay of scoliosis treatment is nonsurgical management including activity modification, pain management, spinal injections, physical therapy, heat and cold therapy, acupuncture, and chiropractic manipulation. If that is insufficient nerve ablation with a special probe can destroy part of the painful nerves to stop pain signals to the brain. If that is unsuccessful to relieve pain and improve function, surgery may be necessary to restore quality of life.
What is spinal reconstruction surgery?
Spinal reconstruction surgery is complex surgery designed to treat severe spinal deformity and misalignment that affects a major part of the spine from scoliosis. Spinal reconstruction surgery can also treat severe kyphosis, an excessive curvature of the thoracic spine that causes a rounded upper back.
The goal is to fix the curvature, improve spinal alignment and balance, and improve cosmetic appearance. It usually involves spinal fusion and may also include decompression surgery (a laminectomy) for spinal stenosis or disc degeneration. Spinal fusion is surgery to fuse two or more vertebrae to eliminate painful movement. It has a solid record of safety and efficacy in the treatment of scoliosis.
Spinal reconstruction surgery is only performed by surgeons like Dr. Federico Girardi who possess extensive knowledge and experience in treating spinal deformity disorders. Dr. Girardi will determine sources of your pain and will tailor surgery to meet your needs.
Open surgery has been the mainstay procedure, but minimally invasive spine surgery is an option. All treatment decisions are made on a case-by-case basis. The goal is pain relief, restoration of stability, and reduced disability.
Dr. Federico Girardi specializes in the surgical treatment of spine disorders and has extensive experience in minimally invasive spine surgery. Dr. Girardi is internationally renowned, trains spine surgeons world-wide in advanced surgical skills including minimally invasive spine surgery and has extensive clinical research experience.
Contact his office to schedule a consultation at the Hospital for Special Surgery (HSS) in Manhattan. HSS is the number one US hospital in Orthopedics.
At a Glance
Dr. Federico Girardi MD
- Triple fellowship-trained spinal surgeon
- Performs over 400 spinal surgeries per year
- Professor of orthopedic surgery at Cornell University
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