At Shoreline Orthopaedics, our orthopaedic surgeons use a truly collaborative approach so our patients have the benefit of multiple expert opinions, without having to go elsewhere to obtain them.
Shoreline Orthopaedics provides more comprehensive services, state-of-the-art options, technologies and techniques than anyone else in the area.
The following information is provided to help you understand what you can expect from us regarding policies and procedures, and also what is expected of you before and after treatment or procedures.
The spinal column is made up of small bones (vertebrae) stacked on top of one another, creating the natural curves of the back. Between the vertebrae are flat, round, rubbery pads (intervertebral disks) that act as shock absorbers and allow the back to flex or bend. Muscles and ligaments connecting the vertebrae allow motion while providing support and stability for the spine and upper body. Each vertebra has an opening (foramen) in the center and these line up to form the spinal canal. Protected by the vertebrae, the spinal cord and other nerve roots travel through the spinal canal. Nerves branch out from the spinal column through vertebral openings, carrying messages between the brain and muscles. Facet joints align at the back of the spinal column, linking the vertebrae together and allowing for rotation and movement. Like all joints, cartilage covers the surface where facet joints meet.
The spine contains three segments: lumbar, thoracic and cervical. The lumbar spine consists of five vertebrae located in the lower back; lumbar vertebrae are larger because they carry more of the body's weight. The thoracic spine consists of 12 vertebrae and begins at the upper chest, extending to the middle back and connecting to the rib cage. The cervical spine includes the neck and consists of seven small vertebrae, beginning at the base of the skull and ending at the upper chest. Disks in the lumbar spine are composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus). In the cervical spine, disks are similar but smaller in size.
The term kyphosis is used to describe the spinal curve that results in an abnormally rounded back. Although some degree of rounded curvature of the spine is normal, a kyphotic curve that is more than 50° is considered abnormal. There are several types and causes of kyphosis.
A visit to the doctor is typically the result of a scoliosis examination at school, a child's or parent's concern regarding the cosmetic deformity of a rounded back, or pain. The physician's exam may include asking the child to bend forward so that the slope of the spine can be assessed. Spinal X-rays will reveal any bony abnormalities and will help measure the degree of the kyphotic curve.
Recommended treatment will depend on the reason for the deformity. Most teens with postural kyphosis will do well throughout life, and for some, posture may improve over time. An exercise program may help relieve any associated back pain. A spine conditioning program may be recommended. For patients with Scheuermann's kyphosis, an initial program of conservative treatment that includes exercises and anti-inflammatory medications (for discomfort) is recommended. If the patient is still growing, the physician may prescribe a brace, typically worn until skeletal maturity is reached.
If the kyphotic curve exceeds 75°, surgery may be recommended to: reduce the degree of curvature by straightening and fusing the abnormal spinal segments together; maintain the improvement over time; and alleviate significant back discomfort, if present preoperatively.
As with any surgery, there are some risks, and these vary from person to person. Complications are typically minor, treatable and unlikely to affect your final outcome. For most people, surgery can provide relief of symptoms and return to function with relatively low risk of complications. Overall, elderly patients have higher rates of complications from surgery, as do patients who are overweight, diabetics, smokers, or suffering from multiple medical problems. Among the general, potential risks associated with surgery are infection, bleeding and blood clots, and reactions to anesthesia. Be sure to discuss the potential risks and benefits with your surgeon prior to surgery.
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