Deformity

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Spine deformities can cause debilitating pain and seriously impact function, self-image and overall quality of life.

Spine deformities include:

  • Ankylosing Spondylitis
  • Kyphosis
  • Scoliosis
  • Spondylolisthesis

Patients with complex spinal deformities may require:

  • Surgery
  • Rehabilitation
  • Pain control
  • Physical medicine
  • Bracing
  • Orthotics

Ankylosing Spondylitis

Ankylosing spondylitis is an inflammatory condition that involves the spine and skeleton of the head and trunk. The disorder causes inflammation and pain in joints in the spine, pelvis and other parts of the skeleton. In addition, parts of the spine, the sacroiliac joints where the hips join the lower back, or the hips may fuse, or grow, together.

The typical patient is a young male, aged 20–40. Men are affected more than women by a ratio about of 3:1. The disease usually takes a more painful course in men than women.

Symptoms include:

  • Pain
  • Stiffness, especially in the morning
  • Functional limitation

When the disorder affects the spine, it also may result in progressive deformity including curvature of the back, called kyphosis, and the inability to stand up straight.

No cure is known for ankylosing spondylitis, although treatments and medications are available to reduce symptoms and pain. Physical therapy and exercise, along with medication, are the most common forms of therapy.

Kyphosis

Kyphosis describes the exaggerated curve of the spine that results in a rounded or hunched back. Kyphosis may develop for several reasons. Postural kyphosis in children and adolescents may be related to habit and posture rather than underlying spinal deformity. In contrast, structural kyphosis refers to a round-back posture that is not reversible by paying attention to your posture and making an effort to sit and stand up straight. In adolescents, structural kyphosis may be caused by initial spine development with a rounded shape that is made worse by further growth. In the elderly, compression fractures characteristically result in loss of height and kyphotic deformity.

Symptoms of kyphosis include:

  • Back pain
  • Difficulty standing with an upright posture
  • Early fatigue to the back and legs

Kyphosis causes a bowing of the back, seen as a slouching back, as well as breathing difficulties. Severe cases can cause great discomfort and even lead to death.

Treatments include:

  • Body braces
  • Physical therapy
  • Surgery (in severe cases)

Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra slips forward on the one below it.

In children, spondylolisthesis may occur as the result of a birth defect that affects the back of the spine or be caused by stress fractures within the back part of the spine. Spondylolisthesis is the most common cause of low back pain in adolescent athletes. In older people, the most common cause is degeneration of the discs between the vertebrae. With aging, the discs lose moisture, dry out and flatten, bringing the bones on either side closer together to the point where one slips forward on the other.

Typical symptoms of spondylolisthesis include:

  • Pain across the lower back
  • Hamstring tightness
  • Cosmetic deformity
  • Radiculopathy
  • Abnormal gait

However, a person can have the condition and not have pain.

Most often, treatment for spondylolisthesis includes:

  • Physical therapy to strengthen the back muscles
  • Pain medication
  • Bed rest
  • Wearing a back brace or corset

Children and adolescents whose spines have slippage greater than 30 percent to 50 percent may be candidates for spinal fusion surgery. Children and adults who have persistent pain despite non-operative care also may be considered for surgery.

Surgery for spondylolisthesis may involve decompression of the nerve roots by removing bone and/or intervertebral disc material, followed by fusion of the vertebrae with or without bracing.