Surgery for correction of spinal deformities
What is a Spinal Deformity?
A spinal deformity occurs when your spine varies by more than 10 degrees from “healthy” curvature. But, what does this mean exactly?
Contrary to popular belief, your spine isn’t 100% linear. But, this statement isn’t entirely false either. In reality, your spine consists of a series of gentle arcs. Your lumbar spine, or lower back, swoops slightly inward and your thoracic spine, or upper back, bends subtly forward. The inward curve of your lower back is known as lordosis and the outward curve that runs between your shoulder blades is known as kyphosis.
But, when viewed head-on, your backbone should look like a straight pillar. (Hence, doctors often refer to the spine as the “vertebral column.”)
Moreover, the curves and straight stretches of your spine make symmetry possible. Your head sits directly over your pelvis because the lordosis of your lower back and the kyphosis of your upper spine balance each other out. If one of these curves becomes greater or lesser than the other, then problems can emerge. We refer to this as sagittal imbalance, because the head and pelvis no longer fall within the same, or sagittal, plane.
Although somewhat confusing, too much swayback is simply known as lordosis and too much forward stooping in the upper back is known as kyphosis.
Likewise, when the spine tilts away from the midline of the body, doctors refer to this problem as coronal imbalance or scoliosis. Unevenness in the “coronal” plane (the view from head-on) causes asymmetry in the trunk of the body. This can include uneven hips and shoulders or one-sided bulging of the ribs.
What are the Major Types of Spine Deformities?
As touched upon, the major types of spinal deformities include:
- Scoliosis: An abnormal side-to-side arc in the spine. If your spine curves to the right, then you have dextroscoliosis. If your spine curves to the left, then you have levoscoliosis. However, often, adult and pediatric patients with scoliosis will have more than one twist in their spine.
- Kyphosis: This occurs when the upper back develops a forward hump, sometimes referred to as hunchback. The shoulders will round forward, the head will jut out, and the torso will appear to slouch or droop over.
- Lordosis: This often occurs as a side effect of kyphosis. Hyper-lordosis, or swayback, causes the lower back to swoop inward and the abdomen to jut outward.
- Flatback Syndrome: This condition develops when the spine loses its natural curvature. This may sound benign. After all, the spine has become “straight.” But, flatback syndrome can cause patients to pitch forward, creating serious issues with walking.
- Ankylosing Spondylitis: This form of arthritis can cause the spinal vertebrae to fuse together. When this occurs, your spine loses its mobility and your posture locks into one position.
- Spondylolisthesis: Also known as a slipped vertebra, this condition can be caused by a birth defect in the spine. In the severest cases, a slipped vertebra can slide entirely off of the spinal column, a condition also known as spondyloptosis.
What Causes Spinal Deformities?
Doctors sort spinal deformities into different groups according to their causes. Although many issues can cause spinal deformities, the most common include:
- Congenital: Some forms of spinal deformity develop before a child is born. Genetics and mishaps in the womb can cause this.
- Pediatric: Other forms of spinal deformity become more obvious in childhood. Scoliosis, for instance, often emerges between the ages of 10-12. Specifically, growth spurts may cause this jump in rates.
- Postural: Poor posture in key periods of spinal growth can cause the upper back to round forward. To fix this issue, muscle-strengthening and posture lessons may be needed.
- Neuromuscular: Certain disorders, like cerebral palsy, can alter muscle activity. As stiff muscles pull on the spine, the back and neck can lose their natural shape.
- Adult or Degenerative: Wear and tear on the spine can cause the discs in your back to degenerate. Weak vertebrae can fracture and develop a wedge-shape that leads to kyphosis. And, ligaments that support the spine can harden, pulling your back out of alignment.
- Traumatic: Injuries, like sudden blows to the back, can knock vertebrae out of place, altering the curvature of your back.
- Iatrogenic: This fancy word refers to spinal issues, like flatback syndrome, that develop as the result of a failed spinal fusion.
- Idiopathic: When a spinal deformity develops for an unknown reason, the condition is said to be idiopathic. The majority of scoliosis cases, for example, are classified as idiopathic scoliosis.