(bright upbeat music)
- Hi, I'm Susan Taylor with Scripps Health
in San Diego, California.
Every person's spine curves to some degree,
but for some people, that curve becomes too prominent,
and they develop a condition called scoliosis.
Here to talk about symptoms and treatment
is Dr. Greg Mundis.
He's an orthopedic spine surgeon
who specializes in scoliosis.
He's with the Scripps Clinic Medical Group
in La Jolla, California.
Dr. Mundis, thanks so much for being with us.
- Thank you so much for having me.
- So who is at risk for scoliosis?
- So we see two groups of people develop scoliosis.
One is the younger group, usually teenagers or even younger,
where they develop it during their growing years.
The second group that we see affected by this are adults,
usually in their 40s, 50s, or 60s,
where it just shows up, sometimes quite randomly.
- And what causes it?
- Well, the causes of scoliosis can be twofold.
In the kids, we likely think it's more of a genetic cause
where as the child is growing, for whatever reason,
their expression of their genes
that they're born with leads them to have a curved spine.
Now in the adult, things are a little bit different
because what usually happens is that as we age,
arthritis sets in and you can get this degenerative cascade
where the joints in the spine actually deteriorate,
the discs collapse, and when they collapse that way,
you can give the curvature of the spine
that we call scoliosis.
- And what about tumors or infections or accidents?
Can that cause scoliosis as well?
- Sure.
As you can imagine, if you have a tumor in one area
that's causing the spine to twist or maybe an infection
that gets into the disc or the bone,
it can cause a collapse that leads
to the spine to actually curve.
Other things, like you said,
getting into a car wreck and breaking your bone,
can all lead to deformation of the normal spine,
which is supposed to be straight
but then ends up being curved.
- And then what are the symptoms?
- So ironically in kids, there's usually no symptoms.
It's usually picked up by them looking in the mirror
and feeling that things are just a little bit off.
In adults, it's usually pain that leads them to seek help.
- And how is it diagnosed?
- So diagnosis happens in one of two ways.
The first one is clinical.
In other words, we like to see our patients
in person and evaluate their spines.
When you lean forward,
we can actually see the tilt in your back
and then measure the scoliosis
with something called a scoliometer,
and this degree of curvature then prompt us
to use the second way that we diagnose it,
which is an x-ray.
Now this is a traditional x-ray that we typically use
to diagnose it, but at Scripps,
we now have access to a state-of-the-art new x-ray machine
that allows us to take these x-rays
at a fraction of the radiation dose but also
to evaluate the spine as it relates to the entire body.
We can measure the degree of curvature
and where it's located and then be able
to more appropriately recommend management.
- So is there a way to prevent scoliosis,
or is there a way to slow it down?
- In kids, we do know that the use of some brace wear,
especially when the degree of the scoliosis
is a little bit smaller,
can actually help the scoliosis from getting worse.
In adults, we're on a different cascade
because it's the spine that's degenerating
that is leading to the problem.
So anything that we can do to promote our spine health
will hopefully stop that progression from happening.
Having a curve is actually quite normal as we age,
and so what you wanna do is keep the pain at a minimum,
and that's the type of progression
that we would like to prevent.
- So how do you treat scoliosis?
- Well, the way we treat scoliosis
in kids differs actually than we treat it in adults.
In kids, while they're still growing,
we have the opportunity to use a brace
that can actually help the spine straighten
as the child is growing.
And adults are done growing,
so it doesn't work the same way,
so brace wear actually doesn't help very much.
We try all kinds of non-surgical management, however,
for patients that have scoliosis-related pain,
and that can include things like chiropractic care
or acupuncture or physical therapy,
all which can be effective in trying
to help and promote the pain reduction.
If you're having symptoms that are going
into the legs like nerve pain or sciatica,
oftentimes, we'll use nerve blocks
or epidural injections to try to help with the pain
that's associated with the nerves.
And when all these things don't work,
sometimes we have to use surgery to help the problem.
- And how quickly do patients recover from this surgery?
- It really is dependent on how big the surgery needs to be.
There's less invasive surgery,
minimally invasive surgery that sometimes
is applicable in these cases.
Sometimes patients need a bigger operation
to straighten out the spine.
So recovery can range anywhere from a couple weeks
to several months, even up to six months.
- How do you know that you're at the point
when you should go see a doctor about this?
- So the way I like to talk to my patients
is to think of in terms that make sense.
So think about a seven-day week.
If you are plagued by pain for more than four days a week,
that tells me that your back is really limiting you
more times than it's not,
so that's a good time to go seek help.
Certainly, if you have symptoms of shooting pains
down your legs or sciatica or other nerve type of pinching,
then you wanna be evaluated for that as well
because there could be other reasons
for that to be happening.
But certainly, if pain is becoming a factor
in your quality of life,
then I would definitely recommend seeing someone
for some help.
- Any final thoughts, doctor?
- Sure.
I think a lot of patients feel a lot
of anxiety around their spine,
especially if they're having pain their back
or pain in the chest that's coming
from the spine from scoliosis.
I just like to encourage you take ownership of your back.
Exercise, eat well, stay healthy 'cause the chances are,
if you really take care of your body,
then you won't need anything
that's more aggressive as far as treatment,
and you'll be able to get through life hopefully
in a relatively pain-free fashion.
- Dr. Mundis, thanks so much for being with us.
We really appreciate it. - Pleasure's all mine.
- If you want more information on scoliosis,
just click on the link or go to scripps.org/videos.
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At Scripps, we're here for good.
I'm Susan Taylor. Thanks for joining us.
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