Spine Deformities

When viewed from the side, a normal spine stands upright and curves slightly inward near the top, then outward, then inward again near the bottom. This “S” shape enables the spine to provide excellent support and balance to the body while also offering shock absorption to distribute the force of everyday activities like walking.

A deformed spine looks different when viewed from the side. Some well-described spinal deformities include:

• Scoliosis is an abnormal side-to-side curvature. It is easiest to see scoliosis of the spine from the back.
• Lordosis is a deeper-than-normal inward curve of the spine, usually at the lumbar region. Some people refer to lordosis spinal curvature as swayback.
• Kyphosis, or abnormal kyphosis is a greater-than-normal outward curvature of the spine, usually in the upper back and sometimes into the cervical spine (neck).

Causes of spinal deformity range from damaged vertebrae to birth defects. Sometimes, a visible misalignment of the spine is the only symptom of an abnormality. Other times, a spinal deformity might cause pain or even paralysis. For example, a slipped lumbar vertebra may cause pain and leg weakness, whereas a congenital case of kyphosis (hunched back) may cause no symptoms.

All types of spinal deformities should be evaluated and followed by an orthopedic surgeon because the spine plays such a crucial role in overall wellness. While some spinal deformities remain stable and never progress, other types can lead to nerve damage and even organ damage if left untreated. Some people seek treatment for aesthetic reasons due to the appearance of an abnormal spinal curve.

Symptoms of a spinal deformity

The signs and symptoms of a spinal deformity depend on the severity and location of the abnormal spine segment. Many types of spinal deformity do not cause any symptoms beyond a visible abnormality of the spine’s alignment.

• Loss of sensation in the extremities
• Pain to any degree
• Visible misalignment of the spine, either when viewed with the naked eye or on an X-ray film
• Weakness of the legs or arms

Because some types of spinal deformity can occur due to a coexisting condition like muscular dystrophy, you should seek prompt medical attention for any type of spine symptoms. Early diagnosis and treatment offers the best hope for correcting spinal misalignment because the misalignment is easier to correct in the initial stages

Causes

The spine can become deformed for many reasons, including damage to the vertebrae or intervertebral discs and disease processes like osteoporosis. A person also can be born with an abnormally curved spine (called a congenital spinal deformity) due to a malfunction of the genes that regulate spinal development in the embryo. In some cases, spine abnormalities show up later as the child grows and develops. Despite this genetic link, researchers have not established a single inherited trait that makes a person more susceptible to being born with a deformed spine.

Both males and females may be born with a spinal deformity, and older adults are at higher risk of developing a deformed spine due to medical conditions or wear-and-tear.

In some cases, a spinal deformity is deemed “idiopathic,” which means no cause can be identified.

Some of the more common causes of spinal deformity are:

• Accidents, such as falls, that result in spinal fracture (one or more vertebrae)
• Genetic defects that lead to abnormal spine development such as fused vertebral segments
• Infectious diseases like spinal tuberculosis that destroy the bones and other structures of the spine
• Inflammatory diseases, such as arthritis, which can cause bone spurs to develop and push the vertebrae out of alignment
• Neuromuscular diseases like muscular dystrophy that lead to weakness in the muscles that support the spine
• Osteoporosis, which can cause the vertebrae to collapse and result in a hunched back
• Poor posture including poor body mechanics when lifting, which can displace vertebrae or spinal discs

Treatments

Spinal deformity treatment aims to bring the spine into as normal an alignment as possible. This also usually relieves any pain, weakness or loss of sensation associated with the abnormal alignment.

Many orthopedic surgeons will first exhaust all conservative treatments before they recommend spinal deformity surgery. Your treatment options will depend on the type and severity of your spinal deformity. Broken vertebrae, for example, may require immediate surgery to avoid complications like paralysis.

Common treatments for spinal deformity—from nonsurgical to surgical—include:

• Observation and monitoring, particularly in young children, to ensure the spinal curvature does not progress
• Bracing to hold the spine in alignment
• Oral medications or vitamin supplements to treat pain or underlying conditions like osteoporosis
• Corticosteroid injections to reduce inflammation in the affected area of the spine
• Physical therapy and lifestyle changes to include more exercise in order to strengthen back muscles
• Surgery to treat fractures, remove collapsed discs, or fuse misaligned vertebrae