Scoliosis refers to an abnormal curvature of the spine; which can develop in the adult for two reasons. The first is that it may be scoliosis that started when the patient was younger called adolescent idiopathic scoliosis. In other words, this type is not obvious and is often missed. The second type is the degenerative (also called “de novo” which means new) type of scoliosis. As the name implies, it begins in the adult patient usually after age 40 and is thought to be the result of arthritis or degeneration of the spine, with changes in alignment due to degeneration of the discs and the facet joints. This degeneration causes a collapse and wedging of the disc spaces.
It is typically seen in the lower back and is usually accompanied by straightening of the spine from the side. Pain, stiffness, numbness and shooting pain down the legs are seen in symptomatic patients (SRS, 2015).
Since both types of scoliosis can be associated with arthritis, many patients will have back pain and muscle fatigue, as well as possible leg pain. Larger curves (over 40 degrees) should be checked periodically for increase in curve magnitude. Worsening of the scoliosis and/or osteoporosis will cause loss of height along with the other symptoms previously mentioned. Evaluation involves the use of plain X-rays, MRI scans and possibly CT scan. These studies help identify abnormalities in the spine and around the nerve roots and spinal cord that may be associated with the spinal deformity.
Nonsurgical Treatment
Treatment consists of non-steroidal anti-inflammatory medications for pain relief, physical therapy for improving overall function, and exercise to improve strength. If the medications and therapy do not work, steroid or local anesthetic injections in the muscle, joints, or spinal canal may be an option.
Periodic X-rays will show whether the vertebra is changing position.
Surgical Treatment
Surgical treatment is frequently necessary if the curve increases or other symptoms worsen. The type of surgical procedure varies depending on the curve type and size. The most common surgery is a posterior spinal fusion with metal implants and bone graft (from the pelvis or the bone bank), with or without decompression of the nerve roots.
Except for osteoporosis-related scoliosis, most cases of scoliosis cannot be prevented. There is no evidence to suggest that improving posture or doing exercises can prevent adult degenerative scoliosis. Methods to increase bone mass and strengthen bones, including getting enough calcium and vitamin D, and doing regular weight-bearing exercise, may help to prevent cases caused by spinal fractures. In some cases, early detection may prevent the condition from getting worse.
If you have or plan to have children, you should examine your child’s spine regularly starting in infancy, and talk to a health care professional about any concerns. Getting regular school nurse evaluations and pediatric examinations also can identify cases of scoliosis.
Meet
Dr Hamid Mir is a board certified orthopedic spine surgeon with fellowship training in combined neurosurgery and orthopedic spine surgery. He has offices in OC, Los Angeles & Riverside. Dr Mir specializes in spinal fusion, lumbar surgery and treating trauma as well as other conditions affecting the lumbar, thoracic, and cervical spine including degenerative diseases, stenosis, fracture, infection, adult scoliosis, revision, and complex reconstructions.
Testimonials
I was in a very bad situation with a herniated disc in my lower back so I made an appointment with DISC spine center and Dr. Hamid. He was very professional and made me comfortable that he understood exactly what I was going through and was able to communicate effectively exactly what it will take to get me on the road to recovery after spine surgery. It took several months as my injury was severe however I always felt I was in good hands under Dr. Hamid’s supervision…If you ever have the misfortune of injuring your circuit board of your body (spine) you need a pro, do not take advice from anyone who’s not specifically licensed to help, Dr Hamid is who I chose and I’m very thankful.
Dr. Mir saw me about 2 months before the spine procedure and indicated that I had severe stenosis or narrowing of the openings where the nerve roots exit at the L4, L5 and S1 level. He reviewed my MRI and without wasting any time, asked if I wanted or was considering spinal surgery. He was extremely clear and answered all my questions. I had the procedure done at the Disc Newport OP surgery spine center and was cared for by an incredibly competent, caring staff. I was discharged same day and my post op recovery was 2 weeks, and returned to daily activities and work July 15th. The procedure was very successful as my back pain is basically gone. Amazing relief from a procedure done by a great surgeon with a great team!
Dr Mir is an excellent spine surgeon. I had a surgery on my neck by another surgeon but I was still in pain. A friend who had prior spine surgery with Dr. Mir recommended him to me. As the treating surgeon he was very detail oriented, confident, and knowledgeable. His team is very friendly and helpful. I decided to have a second cervical spine operation on my neck. Soooo thankful I have no pain and for physical medicine doctors like him.
Dr. Mir and his entire team of specialists take the extra time and consideration to shape alternatives to meet the needs (holistically) of the patient. Everything about the experience of my surgery was positive. Dr. Mir is a patient and compassionate surgeon. His communication skills are remarkably attentive. We are six months out of the starting gate from surgical treatment, and with PT and core strengthening exercises, this 65 yr. old is back to regular training for next year’s marathon. Thank you kindly El Doc-tor….you are amazing! See you soon.
Dr. Hamid Mir is a member of American Board of Orthopedic Surgery with fellowship training in combined neurosurgical and orthopedic spine surgery at Cedars Sinai Medical Center in 2004. As a top rated spine surgeon, he specializes in cervical, thoracic, and lumbar spine diseases including degenerative, stenosis, fracture, infection, scoliosis, revision, and complex reconstructions.
Dr. Mir focused his practice on minimally invasive techniques. As Medical Director of DISC Sports & Spine Center, Dr. Mir is at the forefront of the field of minimally invasive spine surgery. The benefits of these techniques include less post-operative pain, quicker recovery reduced blood loss, less soft tissue damage, smaller surgical incisions, less scarring and improved function.
ORANGE COUNTY LOCATION
3501 Jamboree Road Suite. 1250
Newport Beach, CA 92660