Spine deformities result from malalignments of the spine; the spine curves or rotates beyond its normal curvature.
Anatomy and Function of the Spine
To understand how spine deformities occur, it is helpful to know the anatomy of the spine and more specifically, the parts of the spine involved. See the section on Spinal Anatomy for more information.
Types of Spine Deformities
Detailed information on common spine deformities, including treatments and case studies, is provided on the following pages:
- Scoliosis
Curvature of the spine to the side as a single curve (shaped like the letter C) or side to side as two curves (shaped like the letter S).
- Kyphosis
Forward curvature of the spine resulting in a rounded or hunch/hump back appearance.
Diagnosis
Making the diagnosis of a spine deformity begins with a complete history of the problem and a physical examination. The main questions your doctor will ask are:
- Family History:
Spine deformities tends to run in families, so it may have a genetic cause. Your doctor will want to know if anyone else in your family has the problem.
- Date of Onset:
When did you first notice the appearance of your spinal condition?
- Measured Curve Progression:
If X-rays have been taken of your spine in the past, the doctor will want to see if the curve is getting worse. The condition can be measured by comparing new X-rays with old ones, measuring the size of the curve, or measuring changes in your height.
- Presence or Absence of Pain:
Not all cases of spine deformities produce pain. If there is pain, your doctor needs to know where it is, what brings it on or intensifies it, and if there is any radicular pain (radiates away from the spine). This usually comes from irritation of the nerves as they leave the spine.
- Bowel or Bladder Dysfunction:
Are you having problems knowing when you have to urinate or have a bowel movement? This is extremely important because it could signal the presence of pressure on the spinal cord or the nerves that go to the pelvis.
- Motor Function:
Has there been a change in how your muscles work? This may be the result of pressure on the nerves or the spinal cord.
- Previous Surgery:
If you have had any surgery on your spine, it may have caused some degenerative scoliosis due to weakened bones or muscles. In order to evaluate your condition properly, it is important that your doctor knows about any previous spinal surgeries.
After taking your history, the physician will give you a physical examination. Your doctor will want to get an understanding of the curve in your back and how it is affecting you. This means first trying to get a "mental picture" of how the spine is curved from examining your back and watching you move. The doctor will look at the flexibility you have by asking you to bend in certain directions.
- Spine Movement:
Is there pain when you twist, bend, or move? If so, where? Have you lost flexibility?
- Flexibility of the Spine:
Checks are done to see if the deformity is fixed in place (rigid) or if the curve changes with your position (flexible).
- Curve Assessment:
This is an observation of the three-dimensional characteristics of the spine. During your physical exam, your doctor will have you bend forward to make the curve evident.
- Rib Hump:
When bending forward, the ribs form a "hump" on the side where the spine is bent. This hump is formed by the altered angle of the ribs where they connect to the curved spine.
- Neurological Exam:
Your doctor will check your nerves by testing sensation, reflexes, and muscle strength.
Usually after the exam, X-rays will be ordered that allow your doctor to see the structure of the spine and measure the curve. You will be asked to hold very still in certain positions. The following images may be taken:
- Front or back view of the entire spine taken from the front or back
- Lateral view of the entire spine taken from the side
- Extension view of the spine while you are bending backwards
Doctors use the Cobb technique to measure curves in the spine. Lines are drawn on the X-ray to form an angle. The doctor measures the angle formed by the line and assigns the number of degrees to the size of the curve.
Depending on the outcome of your history, physical examination, and initial X-rays, other diagnostic tests may be ordered to look at specific aspects of the spine. The most common tests that are ordered are: an MRI to look at the nerves and spinal cord; a CT scan to get a better picture of the vertebral bones; and special nerve tests to determine if any nerves are being irritated or pinched.
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