You are on page 1of 6

Spinal Team

Scoliosis
C o n ta c t D e ta i l s

Spinal Team
Nuffield Orthopaedic Centre
Windmill Road
Headington
Oxford
OX3 7LD

Phone: 01865 738051


Fax: 01865 738027
Web Site www.noc.nhs.uk

Scoliosis Patient Information version 1

© 2007 Nuffield Orthopaedic Centre


Spinal Improvement Group Jan 2007
Your diagnosis
Review Jan 2008
Structure of the Back
Your spine is one of the strongest parts of your body. It is made
of solid bony blocks (vertebrae) jointed by discs to give it
strength and flexibility. It is reinforced by strong ligaments and
surrounded by large powerful muscles that protect it. Where can I find more information?
The spinal cord is the part of the nervous system which lies
within the spine and is protected by it. Nerves branch out from
the cord and carry messages to and from the brain.
www.scoliosis.org – National Scoliosis Foundation
What is a Scoliosis? www.srs.org – Scoliosis Research Society
If you look at people from behind, their spines are mostly www.sauk.org.uk – The Scoliosis Association (UK)
straight. A few people however, have a spine which curves. This
is a scoliosis. The curve can be in one small area of the spine or
can affect the whole spine.

Causes of Scoliosis
For most people (80%) who have a scoliosis a specific cause is
not found (idiopathic scoliosis). The people with this type of
scoliosis are mostly female. It typically develops between the
ages of 10-16. USEFUL TELEPHONE NUMBERS
Some people are born with a scoliosis as a result of abnormal
bone growth during development (congenital scoliosis). Other NOC Main Switchboard - 01865 741155
people have a neurological disorder which then causes a scolio-
sis.
Spinal Secretaries - 01865 738051

Scoliosis does not come from carrying heavy things, athletic


involvement, sleeping/standing postures, or minor lower limb Patient Advice & Liaison Service (PALS)
length inequality.
- 01865 738126

1 10
Surgery
Diagnosis of Scoliosis
The decision as to whether surgery should be advised is always
taken on an individual basis after discussion between the individ- As part of your assessment you will be asked to stand and bend for-
ual and the scoliosis specialist. Surgery may be recommended if: wards with your knees straight. If you have a scoliosis it is more
obvious in this position because the ribs are not symmetrical.
• your curve has increased in size
• taking a deep breath is difficult because of your curve X Rays (pictures of your bones) are commonly used in scoliosis as
• pain. the size of the curve can be measured on the X-ray.

Benefits:
Surgery aims to:
• reduce the size of the scoliosis, by rearranging the bones
and holding them in place with screws and other pieces of
bone.
• stop the scoliosis from getting larger.
Risks:
Unfortunately, as with all operations, although every effort is
made to avoid complications, scoliosis surgery carries important
risks. Some of these are mentioned below:
1. Blood loss during surgery.
2. Damage to a nerve happens in less than 1 person out of 100.
3. In 10 out of 100 people the metal screws can cause a problem How noticeable is scoliosis?
and they need to be removed again.
4. Infection is always a risk with an operation. This affects Scoliosis tends to be noticed more by the individual than by other
around 1 in 100 people. Antibiotics are commonly used to people.
prevent this.
Prognosis
5. Dural tear (a tear to the membrane around the spinal cord).
On the whole people with scoliosis do not get any more back pain
Return to activity than people with straight backs.
This is a major operation. Despite this you can get back to light
work or your studies within three months. If you are at school, If the curve is mild or moderate ( <30°) when you stop growing
you can return to this after 1 month. You can gradually return to (around age 18-20) it will probably not get any bigger as you get
all normal activities over the space of one year. Contact sports older. If the curve is quite large ( >30°), the curve may continue to
should be avoided for 1 year after the operation but you can start get bigger as you get older.
gentle exercise such as swimming after 3 months.
9 2
Treatments for Scoliosis Brace
Braces are designed to encourage the bones in your back to grow
If the scoliosis is mild no treatment will be necessary. in the correct direction and not in a curve. They work best for
If the scoliosis is larger and you are still growing then a health people with medium size curves (between 20 – 45 degrees) who
care clinician will review you regularly. Once you have stopped are still growing and their curves are getting bigger. Braces are
growing a hospital review will only be required if the curve gets not very useful if the curve is large or if you are over the age of
bigger or is painful. 18.

Treatment options for medium or large scoliosis are: The braces fit like a vest which is made of plastic. They are often
moulded to your body and padded so that they don’t rub. The
1. Exercise brace can be worn underneath your clothes. Your consultant will
2. Bracing advise you on how often to wear it. You will probably need to
3. Surgery wear this jacket until your bones are mature which is approxi-
mately when you are 16 or 17 years old.
The health care clinician will advise you on the best treatments
for your scoliosis. Manual therapies
There is no reliable evidence that manual therapies that can be
What sort of exercises should I be doing? part of osteopathy, chiropractic, physiotherapy, reflexology or
acupuncture treatments can change the structure of a scoliosis.
It is important to keep fit. Any exercise is good for scoliosis, but
stretching and strengthening exercises for the spine are the most
useful. Some exercises can be given to you with this booklet. A
physiotherapist could help you to tailor an exercise programme to
your needs if you would like this. Ask your Consultant how you
can be referred to a physiotherapist.

Should I stop doing anything?


No. There is no need to restrict activity because of your scoliosis.
You can lead a perfectly normal life with a scoliosis so keep do-
ing all your favourite sports and activities.

3 8
Strengthening exercises Stretching exercises

Sit down then stand up repeatedly without


using your arms. To maintain/improve forward bending of the spine

Lying on your back

Use your hands to pull your knees


towards your chest

To improve the arm muscles

Standing Kneeling on all fours

With one arm lift a weight above Arch your back


your head
(e.g. bottle of water or a tin can)

Repeat on the other side

To improve your general fitness To maintain/improve backward bending of the spine

Kneeling on all fours

Hollow your back

Lying on your front

Lean on your elbows


Cycling Brisk walking Jogging

7 4
Stretching exercises Strengthening exercises

To maintain/improve side bending of the spine To improve the trunk muscles

Lying on your back Lying on your back

Make one leg longer Tighten the tummy

Repeat on the other side Lift the head and shoulders

Standing
Lying on your front
Stretch your arm above your head
Put your hands above your head
Lean over to the side
Lift your hands and shoulders upwards
Repeat to the other side

To improve the leg muscles


To maintain/improve hip and hamstring mobility
Standing
Lying on your back
Lift one leg towards the opposite arm
Use your hands to bend one
Repeat on the opposite side
knee towards your chest
Standing
Repeat on the other side
Step on and off a step

Change to leading with the opposite leg


Lying on your back

Place your hands behind one


knee
Lean over a stable surface at hip
height
Gently straighten the leg
Lift one leg backwards
Repeat on the other side
5 6