Scoliosis: Treatment Needs and Long-Term Effects

Spinal curvature assessment

Hello, doctor.
I would like to ask if scoliosis requires treatment.
If left untreated, what are the potential complications? Will the treatment take a long time? My condition is not very severe...
I'm just wondering if correcting the curvature would mean I would be taller.
Also, I saw an advertisement on TV that said if you sit for a while, your legs get numb and your back aches, it indicates a spinal issue.
Is that true? I was in a car accident once, and my right leg was injured.
After that, I noticed that when I sit for a while, like when I use the restroom, I don't stay there longer than before, but my leg starts to feel numb halfway through, very numb...
Could it be that the car accident affected my spine? Thank you.

Gina, 10~19 year old female. Ask Date: 2005/02/03

Dr. Shi Guozheng reply Orthopedics

Scoliosis should be considered for surgical treatment if the curvature exceeds 40 degrees.
If the curvature is between 20 and 40 degrees, bracing may be considered, particularly in patients who have not yet completed their growth.
In adults, surgery is only considered if the curvature is greater than 40 degrees and there are functional impairments.
Correcting the scoliosis can slightly increase height.
If there is spinal injury from a car accident, pain and numbness may occur even when not sitting, and if the right leg is injured, there may be localized pain and numbness due to issues with the surrounding tissues.
If you have any questions, it is advisable to consult a physician and consider getting an X-ray.

Reply Date: 2005/02/03

More Info

Scoliosis, or spinal curvature, is a condition that affects the alignment of the spine. It can vary in severity, and while some individuals may have a mild curve that does not require treatment, others may experience significant curvature that can lead to various complications. Understanding the need for treatment, potential long-term effects, and the relationship between scoliosis and other symptoms like leg numbness or back pain is crucial for managing this condition effectively.

Treatment Needs for Scoliosis
Whether scoliosis requires treatment largely depends on the severity of the curvature and the age of the patient. In mild cases, especially in adults, treatment may not be necessary. However, if the curvature is moderate to severe, or if it is progressive, treatment options may include:
1. Observation: For mild scoliosis, especially in adults, regular monitoring may be sufficient. This involves periodic check-ups to ensure that the curvature does not worsen over time.

2. Bracing: In adolescents, if scoliosis is detected early and the patient is still growing, a brace may be recommended to prevent further curvature. Bracing is typically effective for curves less than 25 degrees.

3. Physical Therapy: Exercises may help improve posture and strengthen the muscles around the spine, potentially alleviating some discomfort associated with scoliosis.

4. Surgery: In severe cases, particularly when the curvature exceeds 45-50 degrees, surgical intervention may be necessary. The most common procedure is spinal fusion, which stabilizes the spine and corrects the curvature.

Long-Term Effects of Untreated Scoliosis
If scoliosis is left untreated, especially in more severe cases, it can lead to several long-term complications, including:
- Chronic Pain: As the spine continues to curve, it can lead to chronic back pain and discomfort.

- Respiratory Issues: Severe scoliosis can affect lung function due to reduced space in the chest cavity.

- Cardiovascular Problems: In extreme cases, the heart may be compressed, leading to cardiovascular issues.

- Postural Changes: Over time, untreated scoliosis can lead to noticeable changes in posture, which may affect overall body mechanics and lead to further musculoskeletal problems.

Treatment Duration and Height Considerations
The duration of treatment varies significantly based on the individual's condition. For those requiring bracing, treatment may last until skeletal maturity, which can be several years. Surgical recovery can also take months, with rehabilitation necessary to regain strength and mobility.

Regarding your question about height, correcting scoliosis through treatment may lead to a slight increase in height, particularly if the curvature is significant. However, the primary goal of treatment is to prevent further progression of the curve and alleviate any associated symptoms rather than to increase height.

Connection Between Scoliosis and Other Symptoms
You mentioned experiencing leg numbness and back pain, particularly after sitting for extended periods. While scoliosis can contribute to discomfort and nerve compression, it is essential to consider other factors, especially given your history of a car accident. The numbness in your legs could be related to nerve compression due to spinal misalignment or injury from the accident.
If you are experiencing persistent symptoms like numbness or pain, it is advisable to consult a healthcare professional. They may recommend imaging studies, such as X-rays or MRIs, to assess your spine's condition and determine if there is any nerve involvement or other underlying issues.

Conclusion
In summary, scoliosis can require treatment depending on its severity and the patient's age. Untreated scoliosis can lead to chronic pain and other complications. The duration of treatment varies, and while some height increase may occur with correction, the primary focus should be on managing symptoms and preventing progression. If you have concerns about your symptoms, especially in relation to your past injury, seeking professional medical advice is crucial for appropriate evaluation and management.

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