Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine. Lordosis is a curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine. People with scoliosis develop additional curves to either side, and the bones of the spine twist on each other, forming a "C" or an "S" shape in the spine.
Scoliosis is about two times more common in girls than boys. It can be seen at any age, but it is most common in those over 10 years of
age. Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curve from one generation to the next.
Scoliosis can affect about 2% of females and 0.5% of males. In most cases, the cause of scoliosis is unknown (idiopathic). This type of scoliosis is described based on the age when scoliosis develops. If the person is less than 3 years old, it is called infantile idiopathic scoliosis. Scoliosis that develops between 3 and 10 years of age is called juvenile idiopathic scoliosis, and people that are over 10 years old have adolescent idiopathic scoliosis. More than 80% of people with scoliosis have idiopathic scoliosis, and the majority of those are adolescent girls.
There are three other main types of scoliosis:
Functional: In this type of scoliosis, the spine is normal, but an abnormal
curve develops because of a problem somewhere else in the body. This could be
caused by one leg being shorter than the other or by muscle spasms in the back.
Neuromuscular: In this type of scoliosis, there is a problem when the bones of
the spine are formed. Either the bones of the spine fail to form completely or
they fail to separate from each other during fetal development. This type of scoliosis develops in
people with other disorders, including birth defects, muscular dystrophy,
cerebral palsy, or Marfan's disease. People with these conditions often develop a long C-shaped curve and have weak muscles that are unable to hold them up straight. If the curve is present at birth, it is called congenital. This type of scoliosis is often much more
severe and needs more aggressive treatment than other forms of scoliosis.
Degenerative: Unlike the other forms of scoliosis that are found in children and teens, degenerative scoliosis occurs in older adults. It is caused by changes in the spine due to arthritis known as spondylosis. Weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs can lead to an abnormal curvature of the spine. The spine can also be affected by osteoporosis, vertebral compression fractures, and disc degeneration.
Others: There are other potential causes of scoliosis, including spine tumors such as osteoid osteoma. This is a benign tumor that can occur in the spine and cause pain. The pain causes people to lean to the opposite side to reduce
the amount of pressure applied to the tumor. This can lead to a spinal deformity.
If the Doctor Recommends Surgery, Which Procedure Is Best?
Many surgical techniques can be used to correct the curves of scoliosis. The main surgical procedure is correction, stabilization, and fusion of the curve. Fusion is the joining of two or more vertebrae. Surgeons can choose different ways to straighten the spine and different implants to keep the spine stable after surgery. (Implants are devices that remain in the patient after surgery to keep the spine aligned.) The decision about the type of implant will depend on the cost; the size of the implant, which depends on the size of the patient; the shape of the implant; its safety; and the experience of the surgeon. Each patient should discuss his or her options with at least two experienced surgeons.
Patients and parents who are thinking about surgery may want to ask the following questions:
What are the benefits from surgery for scoliosis?
What are the risks from surgery for scoliosis?
What techniques will be used for the surgery?
What devices will be used to keep the spine stable after surgery?
Where will the incisions be made?
How straight will the spine be after surgery?
How long will the hospital stay be?
How long will it take to recover from surgery?
Is there chronic back pain after surgery for scoliosis?
Will the patient's growth be limited?
How flexible will the spine remain?
Can the curve worsen or progress after surgery?
Will additional surgery be likely?
Will the patient be able to do all the things he or she wants to do following surgery?
SOURCE: National Institute of Arthritis and Musculoskeletal and Skin Diseases