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Old 21-06-2012, 03:33 PM
Dr Scoliosis Dr Scoliosis is offline
 
Join Date: Apr 2009
Posts: 187
Default Re: Some additional remarks

Georgie was found to have an idiopathic thoracic scoliosis when she was 12 years old during her growth spurt. The curve progressed and a bracing program was commenced in her 13th year. Georgie was "very flexible" as she had a moderate degree of generalised ligamentous laxity, that is, the range of motion at most of her joints was greater than the average normal. Hence, not unexpectedly, quite a good curve correction was obtained with the brace. However, when the time came for her to be weaned away from the brace, the curve relapsed as sometimes occurs. When she was 17 her curve was approaching the surgical category but it then remained unchanged over several years. Throughout adolescence Georgie had remained extremely fit and trim by regularly exercising several hours a day.

Earlier on Georgie had aspirations to be a ballerina but the magnitude of her curve was such that this was not a practical career option. So she chose to pursue a career in the theatre where she has been most successful.

Georgie did not return for follow-up until she was in her early 40s. By then her curve had progressed considerably but she had only minor back pain and stiffness which she controlled well by daily stretching and exercise. When her symptoms become more troublesome she has found it helpful to work with a physiotherapist until the acute phase settles. She swims regularly, remains quite slender and is also careful not to put excessive strain on her spine in her various daily activities. These precautions have been the key to her successful self-management of the symptoms from her scoliosis, a good example for those with symptomatic scoliosis in early adult life.

Postscript re Scoliosis in the Adult: It is to be appreciated that the indications to treat an idiopathic scoliosis (approximately 90 per cent of all cases of scoliosis) by surgery in adult life are pain and disability. These are extremely difficult symptoms to evaluate. Further, scoliosis surgery in the adult is a very different proposition from the same surgery in a teenager. The incidence of surgical complications is much higher in the adult than it is in the mid-teens. The decision to proceed to spinal fusion in an adult with painful scoliosis is made only after the most careful consideration. It is also important to understand that in adult life there is no direct relationship between pain and disability and either the degree of the curve and/or the severity of secondary "wear and tear" changes as seen on the spinal x-ray.

Dr Scoliosis