Patient information
Spinal deformity and scoliosis
A change in the shape or balance of the spine can affect how comfortably you stand, walk or carry out everyday tasks. Assessment looks at the spinal curve, your symptoms and what matters to you when considering treatment.
What does spinal deformity mean?
Spinal deformity describes a change in spinal alignment. Scoliosis is a sideways curve, often with some rotation. Kyphosis is an increased forward curve of the upper back. Other alignment changes can make it difficult to stand upright.
A curve may have been present since adolescence or develop later in life. Changes can also follow a spinal injury. This guide focuses on adults; assessment and treatment during growth need a different approach.
Symptoms and assessment
Some curves cause few symptoms. Others are associated with back pain, muscle fatigue, a feeling of leaning forwards or sideways, or reduced walking tolerance. Pressure on nerves can also cause leg pain or altered sensation.
Assessment includes your posture, movement and nerve function, alongside your history and daily limitations. Standing whole-spine X-rays help show alignment and measure curves. MRI or other tests may be useful when nerve symptoms or further questions need investigation.
Care without an operation
A spinal curve does not automatically need surgery. Monitoring may be appropriate when symptoms are limited. Exercise, physiotherapy and a review of pain relief can help with comfort and function, even when they do not straighten an established curve.
The plan depends on whether the curve is changing, which symptoms it causes and your overall health. Discuss what you can safely do and how progress will be reviewed.
When might surgery be considered?
Surgery may be discussed for substantial disability, a worsening deformity or pressure on nerves, particularly when other care has not helped. An operation may relieve nerve pressure, improve alignment and stabilise part of the spine with a fusion.
Deformity surgery can involve a significant recovery. Risks include infection, bleeding, nerve injury, failure of the bones to fuse and further surgery. The expected benefit and risks depend on the proposed procedure and your health; complete pain relief or a perfectly straight spine cannot be promised.
When to seek urgent help
New difficulty passing urine, loss of bladder or bowel control, numbness around the genitals or bottom, or rapidly worsening leg weakness needs urgent medical assessment. Go to an emergency department; call 111 if you need emergency assistance. Do not wait for a reply to an online consultation request.
Questions to discuss
- Is the curve responsible for my symptoms, and is it changing?
- What are the goals of monitoring or treatment in my situation?
- If surgery is considered, what improvement and recovery are realistic?
Arrange a consultation
Dr Baecker consults at Domain Orthopaedic Surgeons in Parnell, Auckland. Self-referrals are welcome.