Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
If the Doctor Recommends Surgery, Which Procedure Is Best?
Many surgical techniques can be used to correct the curves of scoliosis. The main surgical procedure is correction, stabilization, and fusion of the curve. Fusion is the joining of two or more vertebrae. Surgeons can choose different ways to straighten the spine and different implants to keep the spine stable after surgery. (Implants are devices that remain in the patient after surgery to keep the spine aligned.) The decision about the type of implant will depend on the cost; the size of the implant, which depends on the size of the patient; the shape of the implant; its safety; and the experience of the surgeon. Each patient should discuss his or her options with at least two experienced surgeons.
Patients and parents who are thinking about surgery may want to ask the following questions:
What are the benefits from surgery for scoliosis?
What are the risks from surgery for scoliosis?
What techniques will be used for the surgery?
What devices will be used to keep the spine stable after surgery?
Where will the incisions be made?
How straight will the spine be after surgery?
How long will the hospital stay be?
How long will it take to recover from surgery?
Is there chronic back pain after surgery for scoliosis?
Will the patient's growth be limited?
How flexible will the spine remain?
Can the curve worsen or progress after surgery?
Will additional surgery be likely?
Will the patient be able to do all the things he or she wants to do following surgery?
SOURCE: National Institute of Arthritis and Musculoskeletal and Skin Diseases
There are several types of scoliosis based on the cause and age when the curve develops.
Depending on the severity of the curve and the risk for it getting worse,
scoliosis can be treated with
observation, bracing, or surgery.
What is scoliosis?
Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine. Lordosis is a curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine. People with scoliosis develop additional curves to either side, and the bones of the spine twist on each other, forming a "C" or an "S" shape in the spine.
Scoliosis is about two times more common in girls than boys. It can be seen at any age, but it is most common in those over 10 years of
age. Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curve from one generation to the next.
What causes scoliosis?
Scoliosis can affect about 2% of females and 0.5% of males. In most cases, the cause of scoliosis is unknown (idiopathic). This type of scoliosis is described based on the age when scoliosis develops. If the person is less than 3 years old, it is called infantile idiopathic scoliosis. Scoliosis that develops between 3 and 10 years of age is called juvenile idiopathic scoliosis, and people that are over 10 years old have adolescent idiopathic scoliosis. More than 80% of people with scoliosis have idiopathic scoliosis, and the majority of those are adolescent girls.
There are three other main types of scoliosis:
Functional: In this type of scoliosis, the spine is normal, but an abnormal
curve develops because of a problem somewhere else in the body. This could be
caused by one leg being shorter than the other or by muscle spasms in the back.
Neuromuscular: In this type of scoliosis, there is a problem when the bones of
the spine are formed. Either the bones of the spine fail to form completely or
they fail to separate from each other during fetal development. This type of scoliosis develops in
people with other disorders, including birth defects, muscular dystrophy,
cerebral palsy, or Marfan's disease. People with these conditions often develop a long C-shaped curve and have weak muscles that are unable to hold them up straight. If the curve is present at birth, it is called congenital. This type of scoliosis is often much more
severe and needs more aggressive treatment than other forms of scoliosis.
Degenerative: Unlike the other forms of scoliosis that are found in children and teens, degenerative scoliosis occurs in older adults. It is caused by changes in the spine due to arthritis known as spondylosis. Weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs can lead to an abnormal curvature of the spine. The spine can also be affected by osteoporosis, vertebral compression fractures, and disc degeneration.
Others: There are other potential causes of scoliosis, including spine tumors such as osteoid osteoma. This is a benign tumor that can occur in the spine and cause pain. The pain causes people to lean to the opposite side to reduce
the amount of pressure applied to the tumor. This can lead to a spinal deformity.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Marfan syndrome is hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Radiculopathy, a condition in which a nerve or nerves along the spine are compressed causing pain, numbness, weakenss, and tingling along the nerve(s). Some causes of radiculopathy include bone spurs, disc hernation, osteoarthritis, tumors, infection, and neuropathy. Treatment depends on the are of nerve compression. Surgery is generally not required.
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.
Ehlers-Danlos syndromes are genetic disorders that include symptoms such as loose joints, tissue weakness, easy bruising, and skin that stretches easily. There are seven types of Ehlers-Danlos syndromes: Classical type, Hypermobility type, Vascular type, Kyphoscoliosis type, Arthrochalsia type, Dermatosparaxis type, and Tenascin-X Deficient type. Treatment for Ehlers-Danlos syndromes depends on which symptoms are present.
Turner syndrome is an inherited chromosomal condition affecting women. Women with Turner syndrome do not have ovarian function, and features of the syndrome include webbed neck, lymphedema of the hands and feet, heart defects, kidney problems, and skeletal abnormalities. The X chromosome is related to Turner syndrome. Treatment focuses on the symptoms of the syndrome.
Kyphosis is outward curvature of the thoracic spine (upper back). Abnormal kyphosis results in the appearance of a hunchback, which is accompanied by back pain, stiffness, and muscle fatigue in the back. There are three types of abnormal kyphosis: postural, Scheuermann's, and congenital kyphosis. Postural kyphosis is caused by poor posture and a weakening of the back's muscles and ligaments. Scheuermann's kyphosis is caused by a structural deformity of the vertebrae. Congenital kyphosis is caused by an abnormal development of the vertebrae prior to birth. Treatment of kyphosis depends upon the type of kyphosis the patient has.
Charcot-Marie-Tooth disease is one of the most common inherited neurological disorders. Charcot-Marie-Tooth disease affects the peripheral nerves. Symptoms include weakness of the lower leg muscles and foot, foot drop, foot deformities, etc. There are several forms of Charcot-Marie-Tooth disease. Inherited gene mutations are the cause of Charcot-Marie-Tooth disease. There is no cure for Charcot-Marie-Tooth disease; however, therapeutical measures and mild exercise may help symptoms.
Pycnodysostosis (pyknodysostosis) is an inherited disease of the bone. Characteristics of individuals with pycnodysostosis are short stature, brittle bones, short fingers, the midface is less full than usual, a prominent nose, small jaw, and more. There is no cure for pycnodysostosis.
Cleidocranial dysplasia is a genetic condition. Cleidocranial dysplasia is also referred to as cleidocranial dysostosis and cleidocranial dysostosis. Cleidocranial dysplasia primarily affects bone and teeth development. Symptoms and signs may vary widely with severity. The RUNX2 is the gene that is related to cleidocranial dysplasia. Cleidocranial dysplasia is an autosomal dominant pattern inherited condition.
Ehlers-Danlos syndromes are a group of disorders which share common
features including easy bruising, joint hypermobility (loose joints),
skin that stretches easily (skin hyperelasticity or laxity), and weakness of tissues.
The Ehlers-Danlos syndromes are inherited in the genes that are passed from parents to offspring. They are
categorized according to the form of genetic transmission into different types with many
features differing between patients in any given type. The fragile skin and loose joints is often a result of abnormal genes that produce abnormal proteins that
confer an inherited frailty of collagen (the normal protein "glue" of our tissues).
In 2001, researchers discovered a new form of Ehlers-Danlos syndrome that is caused by an inherited abnormality in a protein other than collagen that also normally
plays a role in binding together the cells of our tissues (including the skin, tendons, muscle...