Scoliosis: from detection to treatment

Free Malaysia Today

6 days ago

Individuals should undergo spinal checkups and exercise regularly to maintain spine strength and prevent future complications. (Envato Elements pic)
KUALA LUMPUR : As a healthy spine should appear straight, signs of a sideways curve like the letter 'S' or 'C' could be a sign of scoliosis. According to spine surgeon Dr Saw Lim Beng, this condition features an abnormal sideways curvature of the spine.
'Unlike a normal straight spine, scoliosis causes uneven shoulders, a tilted body, and a bulging rib cage or hump at the loin, usually on one side, leading to physical imbalance,' he explained.
Saw said it is important to recognise early signs of scoliosis, like uneven shoulders or asymmetrical pelvic level. He noted that a 2017 publication found that scoliosis affects 2-3% of the local population, with less than 0.1% being severe cases.
'Most cases are relatively mild, with curvatures ranging between 10° and 20°, especially in growing children,' he added.
Scoliosis in children is most commonly idiopathic, that is, with no known cause. Other forms of the condition include congenital scoliosis (present at birth), neuromuscular scoliosis (linked to conditions such as cerebral palsy), and degenerative scoliosis (common in older adults due to spinal degeneration).
He said the best time for children to undergo spine screening is typically between the ages of 10 and 15, as this is when scoliosis is most likely to develop.
Scoliosis involves an abnormal curvature of the spine. (Wikipedia pic)
Scoliosis can often be detected through a clinical examination, such as the Adam's Forward Bend Test, where doctors observe the child's asymmetrical rib cage as he or she bends.
Treatment for scoliosis varies depending on the severity of the curve and the patient's age. 'For curves under 20°, observation is usually sufficient for both growing children and adults,' Saw said.
'When the curve ranges between 20° and 40°, growing children are typically prescribed a brace and monitored closely, while adults may be observed at two- to three-year intervals.
'For curvatures exceeding 45°, surgery may be recommended for both children and adults.'
Although scoliosis surgery has proven effective, Saw cautioned that it carries potential risks such as nerve injury, which could lead to paralysis. Other complications include infections and spinal imbalance after surgery.
Dr Saw Lim Beng.
That said, Saw highlighted that new technologies are making spinal surgery safer and more precise. 'Robotic-assisted procedures, real-time navigation systems, and patient-specific rods have helped reduce risks and enhance precision.
'Surgery that once took up to eight hours can now be completed in just two to four hours, with most patients discharged in a day or two.'
Saw stressed the importance of maintaining good alignment to prevent long-term damage to the spine and joints, noting that poor posture and weak core muscles could lead to spinal issues, even while performing everyday activities such as lifting or bending.
He further advises individuals to undergo spinal checkups and exercise regularly to maintain spine strength and prevent future complications.