What Are the Basics of Scoliosis?

Answer 1

I have severe scoliosis.  Adult onset.  I am 54 and this condition seemed to have started when I turned 50.  I have 14 screws and fusions in my neck that end st T1.  At this point I can barely walk due to excruciating lower back pain.  I also suffer from pain at T3.  I have developed pain in the middle of my chest that I assume is from being so bent over.  This is causing this area to be squashed together.  I am being told that I need an XLIF , extreme lateral inner body fusion from T3 all the way down through my pelvis.  Is anyone familiar with this procedure?  Any help would be greatly appreciated.

Comments

The Extreme Lateral Interbody Fusion (XLIF) is a useful procedure for a number of conditions that require fusion of the lumbar spine such as degenerative conditions, instability, and deformity of the lumbar spine. It can be performed at multiple lumbar levels although in most patients it is performed only at one or two levels. Most surgeons limit the procedure to upper and mid lumbar levels (L1-2, L2-3, L3-4) because of the risk of injury to the sensory nerves to the legs when the XLIF is performed at lower (L4-5, L5-S1) levels. While the XLIF may be performed as a single ‘stand alone’ procedure, in most cases it is combined with a posterior decompression and/or stabilization procedure with pedicle screws and rods.

The Extreme Lateral Interbody Fusion (XLIF) can be performed through a minimally invasive or mini-open approach. The procedure is usually performed with the patient under general anesthesia. The patient is then positioned on one side. A 3-4 centimeter incision is made on the patient’s side. The abdominal muscles are split to gain access to the space behind the abdomen (retroperitoneal space). The front of the spine is identified and a series of small dilators enlarges the space until a small tubular retractor can be placed on the spine. Small nerve stimulators are used to identify and protect the nerves that travel in the psoas muscle on the front of the lumbar spine. The disc is then removed using specialized instruments. Once the disc is removed a bone graft or interbody fusion device is placed into the empty disc space. Once the interbody device is place the tubular retractor is removed and the small incision is repaired with stiches and a sterile dressing.

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Try to work with a physical therapist who has knowledge of scoliosis rehab. If you do not have access to a scoliosis PT then try a PT who is really good at orthopedics such as a board certification in orthopedics (OCS) and who wholistically treats patients 1-on-1, not 3-4 people in the same hour.

Answer 2

I have scoliosis and have been in physical therapy for 6 weeks and dont feel any relief. What should I do

Comments

The effect of physical therapy is often very limited, you should talk to an Orthopedist about getting a surgery.

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Maybe you should get another therapist, since it didn’t work in 6 weeks. I think I heard that therapists need a special training in re-establishing proper movement patterns in scoliosis, not every therapist gets the training. I also heard a method called Schroth Method something, the spelling might not be right. It’s said to be one of the effective methods. I hope this can help you a bit.

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Check out the Spiral Stabilization Method st the Smizek Clinic in Prague. You can also work with a therapist via FaceTime from London (Spiral Stabilization.co.uk) Checkbout the brilliant information all about muscle chains. Most P.T.’s do not have enough specific training in scoliosis. Also, do not dismiss the Spiral method as ‘too simple’ because it is amazingly effective if you commit to doing the exercises daily- several times daily. All you need is a doorknob to attach the exercise bands to. I did not get diagnosed with scoliosis until age 62 and I have changed the degree of my Cobb angle from 33 degrees to 23 degrees by using Egoscue exercises and now Spiral Stabilization.

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I am 83, and have been treated by a pain Dr. after an epidural at first treatment, I had a pain in my groin, that caused my pelvic to feel locked, I could not walk for about 10 mins. without excruciating pain in my right side. Was scheduled for 4 treatments that at ea. session I was given injections in my spine. I kept having the pelvic pain, he ignored me, and continued with scheduling another treatment of injections. I had begun to lose feeling in my side to the point I could not walk without stumbling. After the 4th round of injections I had to be put in a wheelchair to my ride.  I have not been back.  My primary Dr. felt I needed to see a spine specialist to see what could be to help my numbness in right side.  The spine Dr. was very concerned about my experience with the pain treatments.  After PT for several wks. Without improving he has scheduled surgery for lumbar stenosis.  Should I have doubts about having this surgery?  My surgeon has very high credentials, and tells me he has performed this surgery many times on elderly adults with success.

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Did your surgeon diagnose you with spinal stenosis? Did he perform a MRI scan? I kinda feel that, your symptom is probably caused by an epidural hematoma associated with the injection procedure. Anyway, a MRI scan is very important and should always be done. If it is indeed spinal stenosis caused by a hematona, then surgery should be performed.

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Hi Crystal,
Try to find a physical therapist who has specific knowledge and training in treating scoliosis. There are several effective methods out there.

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Hi Stella,
Stenosis can cause pain such as yours. There is a lot that can be done in PT. A good physical therapist would look at your whole person and check limitations in the hip and pelvis and thoracic spine (mid back).  look for a PT with good orthopedic training (OCS) or residency and fellowship training.  Let me know if you need help finding one in your area.