Today's Edition
Khaled Al Khawaldeh (Abu Dhabi)
Effecting approximately 2% of the population with mostly unknown causes, scoliosis, a condition marked by an abnormal sideways curvature of the spine, presents a multifaceted challenge for patients and medical professionals alike. Dr. Florian Roser, Chair of Neurosurgery at the Neurological Institute of Cleveland Clinic Abu Dhabi, spoke to Aletihad about the intricacies of this disorder and helped shed light how it can be overcome.
“This disorder, characterised by a spine with an ‘S’ or ‘C’ shape, is most often noted among young people hitting puberty. In many cases, individuals may not seek care. However, treatment for scoliosis mainly becomes necessary if a patient begins to experience pain or suffers from image and spinal function-related issues,” Dr. Roser said.
“Some patients may seek to correct the curvature, whereas others may seek to relieve symptoms through medical intervention.”
The cause of this condition remains largely elusive, believed to stem from a blend of genetic predisposition and environmental influences. While scoliosis can affect individuals of any age, it most commonly manifests during the growth phase preceding puberty.
There are several types of scoliosis such as idiopathic, which is the most common and appears during adolescence, congenital, which is present at birth. Neuromuscular scoliosis results from conditions such as cerebral palsy, muscular dystrophy, or spinal cord injuries and the degenerative form of the disease largely affects elderly people.
Diagnosis often involves physical examination followed by imaging tests such as X-rays or MRI scans to gauge the severity and extent of the curvature, which is typically measured in degrees. A curve of 10 to 25 degrees is considered mild, 25 to 40 degrees moderate, and 40 degrees or more is classified as severe.
Dr. Roser emphasised the importance of early intervention for scoliosis, particularly if symptoms such as pain or functional impairment emerge. He said while mild cases may necessitate only observation, moderate to severe instances often warrant active intervention. Treatment modalities range from bracing combined with physical therapy to surgical intervention, depending on the individual’s condition and needs.
He explained that the symptoms of scoliosis can vary significantly depending on the severity and location of the curvature. While mild cases may not produce noticeable symptoms, more severe instances often manifest with distinct signs, including a visible curve in the spine when viewed from behind, uneven shoulders or hips, one shoulder or hip positioned higher than the other, an uneven rib cage, a tilted head, difficulty maintaining an upright posture while standing or sitting, and potential pain in the back, shoulders, or hips.
“Following a diagnosis, a physician may recommend treatment to prevent further curvature and provide a better quality of life. With early intervention, most people with scoliosis can live a normal and active life,” Dr. Roser said.
Cleveland Clinic Abu Dhabi employs advanced surgical techniques to address severe cases of scoliosis. Procedures such as posterior thoracolumbar scoliosis reduction, correction, and fusion with instrumentation, are performed with precision, supported by state-of-the-art technologies. Intraoperative neuro-monitoring (IOM) ensures the preservation of cranial nerve function post-surgery, while real-time CT-guided navigation ensures accurate placement of pedicle screws with precision.
The Spine Care Programme at Cleveland Clinic Abu Dhabi uses a multidisciplinary approach, involving neurosurgeons, orthopaedic spine surgeons, pain management specialists, physical therapists, and nurses.
