Scoliosis is a fairly common condition that can occur at different stages of life, from childhood to adulthood; But congenital scoliosis only occurs in 2% of cases and is one of those with the worst prognoses.
This is stated by Dr. Alberto Méndez Ancona, spine, orthopedic and traumatology surgeon, and who will be the doctor who performs the genetic scoliosis correction surgery on Arely Noh Flores, 12 years old, whose case we announced on Tuesday the 13th. .
The girl is already in the process of preparing for the operation, for which studies are being carried out.
When talking about the minor’s condition, Dr. Méndez Ancona explains that scoliosis is a three-dimensional deformity and goes beyond the appearance of a curvature in the back.
It details that when you have a physiologically normal spine there is a natural curvature at the lumbar, thoracic and cervical levels. In the presence of scoliosis, the spine looks like a straight line, it loses the natural curvature – which is known as lordosis -, this causes a flat back and rotation of the vertebrae.
That is, due to the disease, the natural alignment is lost.
The specialist highlights that for scoliosis to be considered there must be a curvature greater than 10 degrees and there must be vertebral rotation.
Indicates the above because there are people who may have one leg shorter than the other and, for this reason, their spine tends to lean to the side and a curve appears on the opposite side to compensate, but if this curve is less than 10 degrees it cannot be considered scoliosis.
He points out that scoliosis can appear at any time in life and has several classifications: infantile, which occurs from zero to 10 years of age; adolescent or youth, from 11 to 15 years old, and adults, over 60 years old.
infantile scoliosis
In the case of infantile scoliosis, Dr. Méndez Ancona specifies that one can suffer from the congenital type, that is, one that has been present since birth, and represents 2% of cases. It is one of those with the worst prognosis.
This is because there is a malformation in one of the vertebrae, known as hemivertebra, which is not completely formed. The vertebrae usually have a rectangular shape and the hemivertebrae appear to be a triangle.
The aforementioned malformation causes an increase in the curvature of the spine, which may not be perceptible in the first years of life; However, when the boy or girl begins to “grow” the spine also grows and that makes the abnormal curvature more evident.
The specialist adds that scoliosis in childhood can have a neuromuscular origin, which affects people with cerebral palsy, since they usually present spasticity (stiffness or hard muscles), which causes the spine to not grow properly.
In adolescence and youth, idiopathic scoliosis occurs (there is no 100% exact cause) in 80% of cases. It is believed that in women it may have a hormonal origin, since it coincides with the hormonal changes that occur when the first menstruation occurs.
It is a more common condition in women than in men, in a range of 10 to 1 at this age.
Scoliosis in adults usually occurs due to wear and tear due to age.
Dr. Méndez Ancona states that a person with a history of scoliosis in immediate family members, such as parents, grandparents and siblings, has up to a 20% chance of inheriting the problem to their children.
Regarding the symptoms, the specialist indicates that pain is the main wake-up call. In children this manifests itself when they do not want to go out to recess or go to sports classes.
Another symptom is the formation of a hump, which causes discomfort when sitting in a chair with a backrest, and respiratory failure, as there is lack of air even for simple actions such as walking.
It can cause palpitations due to heart failure when the curve is next to the heart.
That is the situation of Arely Noh. He has deformation in the T6 vertebra, one of the thoracic ones, which would equally affect the lungs. Dr. Méndez emphasizes that when the curve is pronounced, it squeezes the heart and does not allow the lungs to expand.
There are some signs that can warn of spinal deformity: neurological alterations that cause spasticity or flaccidity; walking on tiptoe due to stiff leg muscles; changes in sensation, such as numbness, tingling, and cramps in the legs or arms; enuresis (lack of control of urine), and encopresis (lack of control over defecation).
In 26% of cases there may be congenital heart defects and 20% kidney defects.
It is very evident when the problem has already advanced, the asymmetry of the shoulders, the hump and, in the case of women, the breasts.
In the first years of life there are characteristics that can warn of a problem in the spine, not necessarily scoliosis: “café au lait” spots on the back, which is known as neurofibromatosis; skin stigmas such as hair patches, hemangiomas, pilonidal, pilonidal sinus, among others.
The doctor shares that there are times in which orthoses can be used to treat scoliosis, but in the case of congenital hemivertebral scoliosis it is not possible, since the malformation of the vertebra must be corrected so that the problem does not continue.— IRIS CEBALLOS ALVARADO
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