Navigating Complexities Of Adult Scoliosis Complications

KUALA LUMPUR, Oct 22 (Bernama) -- A study has shown that 2.55 per cent of Malaysians aged 13 to 15 are diagnosed with scoliosis, where a patient’s spine exhibits an abnormal lateral curvature, most commonly forming a C-shape or S-shape.

Sunway Medical Centre, Sunway City spine surgeon Dr Saw Lim Beng shared that the condition, which affects adults and children, varies in terms of causes, symptoms and available treatment options.

He explained that scoliosis among adults could occur in two ways: the first develops during childhood or teenage years; and the second is called ‘De novo scoliosis’, which develops in adulthood due to spine degeneration from ageing.

"Both forms can significantly impact daily life if not properly managed.

"The risk factors for developing adult scoliosis include a lack of paraspinal muscle strength due to inadequate exercise, poor bone quality, overuse of the spine from labour-intensive work, poor back care or posture and spine fractures at a young age," he said in a statement.

He said, adult patients with scoliosis often experience regular back pain or body imbalance, including common symptoms such as back stiffness or pain, particularly in areas where the facet joints are compensating for the imbalance, leading to discomfort and soreness. 

Dr Saw pointed that, in severe cases, scoliosis could result in complications such as spinal nerve compression, which might cause leg numbness, weakness and difficulty walking, cautioning that it could lead to reduced exercise tolerance as well as respiratory distress when the thoracic spine is involved.

"To accurately diagnose scoliosis, an X-ray is the best tool as it allows for measuring the Cobb’s angle to determine the severity of the condition. 

"Additionally, a spine magnetic resonance imaging (MRI) analysis is conducted to assess any nerve compression," he said, emphasising that these tools are crucial for evaluating the severity of scoliosis and tailoring a treatment strategy with spine surgeons.

In terms of managing the condition in adults, Dr Saw said treatments were often tailored based on patients’ profiles to optimise outcomes and enhance patients’ quality of life and expectations.

He said this personalised strategy takes into account various characteristics of each patient, including the severity of the spinal curvature, age, overall health status, bone quality, lifestyle habits and specific symptoms.

"This includes conservative treatment or advanced surgical treatment. Conservative approaches often involve physiotherapy or self-exercises like swimming, pilates and yoga to improve spinal flexibility and strength as well as the use of medication to relieve pain or muscle tension.

"Surgical intervention is needed in some cases of adult scoliosis with some careful consideration. However, surgery is not the sole solution to alleviate scoliosis-related discomfort as it can limit spine mobility due to the fixation of the spine, so it is not recommended for patients with mild curves or symptoms," he said.

Dr Saw said the advancement of machinery and surgical techniques available in today's world could assist spinal surgeons in several crucial aspects of the procedure, such as precise monitoring of nerves and enhancing the accuracy of inserting pedicle screws during surgery.

He also said that several pain modulation procedures, such as radiofrequency ablation technique, epidural steroid and various pain block procedures, are available for symptomatic patients who are not keen on major surgical intervention.

Dr Saw also stressed the importance of early detection, comprehensive management and ongoing monitoring in mitigating the progression of scoliosis and improving overall health outcomes.

He recommends that patients go for regular biennial checkups and exercise to maintain spinal flexibility and muscle strength to prevent severe complications and enhance quality of life.

"Additionally, a combination of vitamin D and calcium supplements can help strengthen bones and reduce the risk of fractures and scoliosis progression.

"To mark the Scoliosis Awareness Month, Sunway Medical Centre, Sunway City, Malaysia's largest private quaternary hospital, hosted an event recently, featuring live scoliosis surgery demonstrations, insights from spine surgeons and free screening," he added.

-- BERNAMA