Dextroscoliosis

You may have seen someone who is unable to stand straight because the spine is excessively curved either to the right or left and wondered why. Such a person may have been born that way, with a defect in the spine making him/her unable to enjoy a completely erect posture. If you have ever seen such a case, it’s possible you have seen a case of scoliosis. But when the person’s spine is curved towards the right, such condition is known as dextroscoliosis.

This post will shed more light on dextroscoliosis, its signs and symptoms, causes, as well as the treatment. So, if you are suffering from the condition or know of someone who is, this is the best time to get the right information that will help you. Make sure you read this post to the end and that you understand everything we are going to talk about in the post.

What is Dextroscoliosis?

Picture of Dextroscoliosis

Dextroscoliosis is a medical abnormality in which the vertebral column (spine) is curved towards the right. The curvature is such that the affected individual cannot stand straight without bending to the right. This condition can be a bit distressing in terms of the strain it puts on the muscles of the body or internal organs.

Dextroscoliosis, in most cases, is caused by a congenital abnormality (the individual is born with it), but can sometimes result from other medical conditions. The condition is not as dangerous as levoscoliosis (curvature of the spine to the left), in that, it does not directly put your heart in danger. Nevertheless, the condition puts some pressure on other internal organs such as the liver, kidney (one), the right lung and some parts of the colon.

The condition is commoner at the thoracic and lumbar levels of the vertebral column, hence it is usually referred to as thoracic dextroscoliosis or lumbar dextroscoliosis, depending on the level that is affected. It can be seen in both adults and children. However, the condition is more common in females than in males.

The mild dextroscoliosis is a lesser form of dextroscoliosis in which the spine is slightly curved to the right (just about 10 degrees) and it usually presents with lesser deformity and symptoms as well.

Symptoms of Dextroscoliosis

Symptoms may not be easily pronounced in people who are born with this condition. But X-ray, scan or other form of medical examination may reveal the form of dextroscoliosis and the extent of the abnormality. For the sake of clarity, here are a few symptoms the sufferer may present with:

• There is an abnormal curvature of the spine toward the right side of the body with a prominence of the corresponding scapula
• Difficulty bending down or twisting the body
• Elevation of the left hip above the right side
• The rib cages are asymmetrical (the ribs are at different heights)
• Clothes do not fit properly
• Uneven lengths of the legs
• The patient may lean toward the right side
• The head may be slightly off center
• The baby may lie curved on one side most of the times
• Babies may have a bulge on one side of the chest
• Occasional chest pain or shortness of breath (in severe cases)

Causes

Majority of the cases of dextroscoliosis have unknown cause. Here’s a list of the causes of dextroscoliosis:

• Idiopathic: In this case, the cause is unknown but the patient is born with it (congenital abnormality)
• Degenerative diseases of the spine: When there is a degenerative disease of the spine, the vertebral column could gradually become curved to the right
• Neuromuscular disease: Some diseases that affect the nerves and muscles can equally bring about this condition. Examples include muscular dystrophy and cerebral palsy
• Spinal trauma: Any major trauma to the spine may lead to dextroscoliosis
• Length of the legs: An individual with unequal lengths of the legs may eventually develop dextroscoliosis as he bends consistently towards the shorter leg
• Bad posture: Assuming certain bad postures for a long period can also bring about the condition
• Carrying backpacks: If you consistently carry heavy backpacks, there is the tendency of developing dextroscoliosis no matter how mild.

Treatment

Not all cases of dextroscoliosis will require treatment, majority of the children with mild spinal curves will not. But the doctor will need to place them on a regular physical examination to monitor the progress of the curve. In that case, they may need to be on regular follow-ups in every 4 to 6 months during which periods X-rays and other forms of tests are conducted.

However, before any treatment is commenced, the following will help the doctor in making a decision:

• Severity of the curve: Curves that are larger tend to get worse with time. For instance, S-shaped curves otherwise known as “double curves” usually get worse as time goes by; the C-shaped curves may not get worse
• Maturity of the bone: If the patient’s bones are no longer growing, the risk of the condition getting worse is remote compared to someone that is still growing. The most effective way to handle the condition while the bones are still growing is to use braces
• Gender: Dextroscoliosis tends to get worse in females than in males. This is a fact that the doctor would have to look into before making a decision to treat the patient
• Position of the curve: Curves that are located in the center of the back tend to get worse with time compared to those located in the upper or lower portions.

Now that the doctor has made a decision to treat the problem, what are the various options available to the patient? Here are some of the ways to handle the problem and give the sufferer some reliefs or provide a permanent solution.

Braces

Most of the times, the doctor would recommend braces for a patient with mild to moderate scoliosis whose bones are still growing. The essence of the braces is to stop any further curvature but it does not reverse or cure the condition. They are supposed to be worn all the times (both day and night). Braces are more effective when worn for a higher number of hours. The braces can be taken off to enable the child take part in physical activity if the brace interferes with such. Braces are no longer needed once the bones have stopped growing.

Usually, there are two types of braces to choose from: Thoracolumbosacral orthosis (TLSO) and the Milwaukee brace.

• Thoracolumbosacral orthosis (TLSO): This is designed to fit neatly around the curves of the body. It can be easily hidden by the patient’s clothing.
• Milwaukee brace: The brace is only needed when there is no available TLSO or when it is impossible to use the TLSO. The Milwaukee brace is a full-torso brace with a neck ring which provides support for the back of the head and the chin.

Casting

The doctor could decide to make use of casting instead of bracing, especially if it is an infant that is involved. Casting will assist the infant’s spine in normalizing during the period of growth. It simply involves the use of Plaster of Paris in making the cast which is attached to the child’s body externally and should remain there all the time. The cast needs to be changed from time to time because of the child’s growth.

Surgery (Spinal Fusion)

Severe cases of scoliosis that cannot be corrected with casting or braces would require surgery. This is because the condition can progress and get worse with time. The primary purpose of the surgery is to prevent the condition from becoming worse.

The surgery involves connecting two or more spine bones with new bone grafts. This can be done with the help of hooks, metal rods, wires or screws which help in holding parts of the spine and keep them straight as healing takes place in the bone.

The average time of the surgery is about 4 to 8 hours. Immediately the surgery is completed, the child would be transferred to Intensive Care Unit (ICU) where he/she would be given further treatment. They are mostly infused with intravenous fluids and given painkillers. The child is out of the ICU within 24 hours and is transferred to the children’s ward where he/she would be nursed and monitored for about one week to 10 days before he’s finally discharged home.

After the surgery, a child would be fit to resume school within 4 to 6 weeks. The child would only be fit to participate in sports after about 1 year of the surgery. The child may need to support the back with a brace for about 6 months only in few cases.

It is important for the patient to visit the hospital at least once in every 6 months so that they can increase the length of the rods. This is done on an out-patient basis. When the spine is fully grown, the rods can then be removed.

Risks

There are some risks associated with spinal fusion. So, the doctor will only weigh the risks against the benefits before going ahead with the procedure. Some of the associated risks include: Pseudarthrosis (improper fusion of the bone), rod displacement, nerve damage and infection.

Conclusion

Dextroscoliosis can pose a problem to internal organs, cause pain or reduce one’s self esteem. But with the tips we have listed in this post, you can get the help you want. Note that these suggestions are not to serve as alternatives to medical treatment; they are only there to provide relief. You still need to see the doctor who would determine what to do for you and at what point.