Scoliosis or kyphosis

Crookedness of the spinal column – it’s a question of the correct treatment

It can sometimes be determined from the very first glance during childhood. Other times, lateral crookedness of the spinal column with twisting (scoliosis) or lateral bending of the spinal column (kyphosis) is first discovered during puberty.

The spinal column, the central supportive and movement organ of the body, has a set structure. It is precisely designed, whether looking from the front or from behind. If the frontal plane of the precisely put-together spinal column becomes crooked or bent, pain can occur during everyday movements.

Schoen Clinic specialises in deformities and misalignment of the back. We provided a personalised and tailored range of treatments if you or your child suffer from scoliosis or kyphosis.

Causes & symptoms

What is scoliosis?

A crooked back with twisting when viewed from the front or from behind (scoliosis) often occurs in childhood or adolescence and involves the lateral bending of one or more sections of the spinal column. This can clearly be noticed when looking at the back from behind. The spine twists around its own axis. There is typically also a deviation from the normal profile of the corresponding spinal column segments when viewed from the side. Scoliosis may occur in the thoracic or lumbar spine region. But it can also develop in both regions or connecting regions. Scoliosis can never be fully straightened out, actively or passively. In the advanced stages, the affected section becomes more and more stiff.

Scoliosis often occurs alongside kyphosis (a “hunched back”). This involves lateral bending of the cervical, thoracic or lumbar spine. However, it can also affect the full spinal column.

Causes: how does scoliosis or kyphosis occur?

There are two types of scoliosis: the so-called idiopathic form where the cause is not known, and scoliosis due to an existing underlying disease. This can include, for example, congenital misalignment of the spine and muscle or nerve disorders. Connecting tissue or metabolism disorders can also play a role. Most cases, however, involve idiopathic scoliosis. This occurs in childhood or adolescence and frequently advances during puberty.

Kyphosis can also be inherited. It can otherwise occur after an accident, surgery or a tumour. Even misalignments and disorders such as Scheuremann’s disorder, osteoporosis and chronic joint inflammation can cause kyphosis.

Scoliosis symptoms or kyphosis symptoms: signs indicating a disorder

There’s not always clear evidence of a disorder, apart from the malformation of the spinal column. Scoliosis in children typically only triggers physical pain in rare cases. One exception, for example, is a measurable reduction in lung function due to severe crookedness.

In the later stages of the disorder, however, the malformation and asymmetry of the torso often causes psychological or psychosocial distress as patients are shamed for their appearance.

In adults, the long-term deformity and incorrect load-bearing then causes increased back pain. The crooked region of the spinal column sometimes stiffens, limiting movement.

Severe scoliosis in adults causes malformation and shortening of the torso and therefore also a reduction in the chest and stomach cavities. This can noticeably impair internal organs such as the lungs, heart or stomach organs. Often, patients report having a shortness of breath or even heart problems.

Kyphosis doesn’t necessarily cause any symptoms. But some patients suffer pain in the region of the crooked thoracic spine. It can also lead to breathing difficulties, circulation issues and feelings of numbness in the arms and legs. Bladder or bowel function can also be disturbed. It causes a reduction in movement, and sleeping disorders can also occur. If a humpback forms due to kyphosis, issues may occur in the bordering spinal column regions, the affected spinal segmented may be worn down faster, and pain and functional issues may be present. Pronounced kyphosis, with visual axis loss, swallowing problems and sometimes even neurological failures, alongside the cosmetic aspects, reduces patients’ quality of life. There is risk involved when chronic rebuilding processes and eventually nerve damages occur due to the constant pressure on the spinal cord with kyphosis. This can ultimately lead to functional failures and paralysis.

Diagnostics

Suspected scoliosis or kyphosis? Our targeted diagnostics provide conclusive evidence

In the initial stages of scoliosis or kyphosis, only a few of those affected have physical complaints. Typically, the disorder first occurs at the start of or during puberty. However, it is crucial to identify the start of scoliosis or kyphosis: the earlier idiopathic scoliosis or kyphosis occurs in childhood or adolescence, the more this incorrect growth progresses during puberty.

Medical history and physical examination

Generally, this sort of misalignment of the spinal column can be recognised early through a general assessment of the spinal column, even if it is already slightly pronounced. After extensively querying your medical history, our specialists carry out a physical examination. In this examination, we assess the extent of the lateral crookedness, and most importantly the hump, as well as the extent of the twisting and the shoulder and pelvis status. We also examine whether your spinal column remains balanced. In addition, we analyse whether there is any deviation from the normal profile by viewing from the side. Often there will also be a pronounced flat back.

Causes investigation: different procedures can provide conclusive evidence

We conduct the bending test for all forms of scoliosis or kyphosis. In this test, the patient bends forwards while standing with their upper body free. By viewing from behind, we can determine how far the ribs bulge behind on the convex side of the crookedness (rib hump) or if any lumbar spine bulges have formed in the lumbar spine region. Lumbar spine bulges also indicate a bulging of the back muscles on the convex side of lumbar spine scoliosis.

When we diagnose scoliosis or kyphosis, we take X-ray recordings of the full spinal column. The patient stands during the X-rays. The images provide us with further information about the form, extent and potential causes of the disorder. The severity of the crookedness or bending can also be measured using X-ray images. To do so, we use a special angle measurement method.

We carry out magnetic resonance imaging (MRI) before all surgical procedures. Particularly with congenital misalignments of the spinal column, the risk of deformities in the spinal canal and spinal cord is higher. Affected regions usually need to be examined in more detail through computer tomography (CT).

It’s also important to examine lung functionality in full, especially with severe forms of scoliosis or kyphosis and before surgery.