Dextroscoliosis Treatment- Orthopedics, Spinal Surgery

Dextroscoliosis is a structural deformity of the spine (backbone). It is a type of scoliosis. Scoliosis is when the curvature of your spine leans abnormally to the sideways. Abnormal curvature can develop anywhere in the spinal column. But it mainly occurs in the thoracic areas (middle and upper portion of the spine), also known as thoracic scoliosis. There are approximately 5200 per 100,000 cases of scoliosis worldwide

If the spine curves abnormally to the right, it is called dextroscoliosis. Whereas if the spine curves abnormally to the left, it is called levoscoliosis. Typically our spine has an S-shaped curve when viewed from the side. The S shape helps in the flexibility of movement and even distribution of weight.

If scoliosis is present by birth, it is known as congenital scoliosis. According to the American Association of Neurological Surgeons (AANS), 80% of forms of scoliosis have no identifiable cause. Adolescent idiopathic scoliosis is a type of scoliosis characterized by an abnormal curving and twisting of the child's spine as they grow.

Treating dextroscoliosis depends on the severity and extent of the abnormal curve. Children and adolescents having a mild curve may not need treatment. But they may need regular checkups and close monitoring to analyze if the curve worsens. However, for a 25 to 40-degree curve, treatment may be necessary. If not treated, it can lead to spinal problems, back pain, and nerve compression, leading to leg pain, weakness, and numbness.

What Is Dextroscoliosis Treatment? How It Works:

To correct abnormal curvature of the spine, surgical or nonsurgical treatments may be necessary, depending on the severity of the condition to prevent worsening of the ailment. In dextroscoliosis treatment, the first goal is to check and correct the underlying cause.

If the condition is not severe, physical therapies may be performed by your doctor. These therapies may not entirely correct dextroscoliosis but build muscles to support the curved spine. If the curvature of the spine is between 10 to 30 degrees, it is regarded as mild to moderate dextroscoliosis. For mild dextroscoliosis, continuous monitoring and X-rays are recommended to examine the progression of the curve.

Curvatures above 35-degree are regarded as severe and may need treatment. Surgical treatments for dextroscoliosis may be recommended if the condition is severe and is causing severe deformities, getting larger and growing with time, or creating other health issues.

Symptoms Of Dextroscoliosis

The symptoms of dextroscoliosis may include:

• A curve in the spine (Spinal curves)
• The upper body is leaning to one side (mainly the right side).
• The head is leaning to one side of the body.
• Varying height of the shoulders.

The symptoms of severe-degree dextroscoliosis or scoliosis include:

• Chest pain
• Back pain
• Leg pain
• Difficulty breathing and shortness of breath.
• Difficulty changing clothes and going to the washroom.

Which Doctor To Consult?

Talk to an orthopedic who will explain to you about your condition, your preferred treatment and its procedure, the risk, and the aftercare.

What To Expect During Dextroscoliosis Treatment?

Dextroscoliosis surgical or non-surgical treatments may not completely cure the structural abnormality of the spine. But it will provide support to the spine and give spinal balance. Moreover, it can ease nerve pressure on your spine, relieving pain and preventing further complications.

Complications Of Untreated Dextroscoliosis

If severe dextroscoliosis is left untreated, it can lead to several complications. Severe dextroscoliosis (above 80 degrees) not only affects the spine and rib cage but eventually damages the lungs, heart, and other internal organs.

Complications of severe dextroscoliosis may include:

• Deformity of the trunk, leading to chest pain.
• Trouble in walking
• Difficulty in bowel or bladder control.
• Reduced gastrointestinal function
• Reduced respiratory function
• Severe back and leg pain.
• Heart and lung damage
• Leakage of spinal fluid
• Nerve or spinal damage
• Intolerable pain.
• Spinal infection
• Breathing problems

Treatment Options For Dextroscoliosis

There are two treatment options for people with scoliosis or dextroscoliosis:

1. Surgical Options
2. Non-Surgical Options

Surgical Options

Several procedures are available for the surgical treatment of dextroscoliosis. Your doctor will best analyze which one of the following suits your condition.

• Metal rods
• Spinal Fusion
• Demivertebra removal

1. Spinal Fusion

In this surgery, the doctor strengthens the spinal bones that are forming the abnormal curve. Then the surgeon fuses the curve back to the correct position using a transplanted bone.

2. Metal Rods

The surgeon attaches two metal rods above and below the spine curvature using screws, wires, or hooks.

3. Demivertebra Removal

This surgical treatment is done to reduce the abnormal curve's severity. It removes one portion of the vertebra and then adds a metal implant.

Non-Surgical Options

For mild scoliosis, doctors may recommend Non-Surgical treatments to manage the condition. An X-ray every six months is necessary to analyze that the scoliosis is no longer growing.

Non-Surgical Options for dextroscoliosis treatment include:

• Bracing
• Physical therapy treatment
• Daily stretching
• Working to improve posture
• Staying active
• Engaging in low-impact exercises like swimming.
• Oral medications to relieve pain
• Epidural or nerve block injections in case of severe pain.
• Dietary changes such as taking nutritional supplements.

Dextroscoliosis Surgery Complications

• Paraplegia. A rare complication of dextroscoliosis leads to loss of movement and sensation in the legs and lower body.
• Excessive Blood Loss: Excessive blood loss is another complication of dextroscoliosis surgery. Before the surgery, the doctor may collect the patient's own blood as a precaution to be transfused during or after the surgery if needed. This is known as autologous blood donation.
• Infection
• Surgery Failure: This is when the spinal fusion surgery fails, a condition known as pseudarthrosis. Its treatment is second spinal fusion surgery.
• Cerebrospinal Fluid Leak

Conclusion

Dextroscoliosis is defined as when the curvature of the spine shifts abnormally to the right. It commonly occurs in children or adolescents. Treatment plans for dextroscoliosis depend on the degree of curvature of the spine and whether the condition is mild to moderate or severe. Moderate scoliosis may need yearly X-rays or X-rays every six months to analyze the condition's progression. In comparison, severe dextroscoliosis may need surgical treatments.

References:

• https://scoliosisinstitute.com/dextroscoliosis-of-the-spine/
• https://www.medicalnewstoday.com/articles/320457#complications
• https://www.healthline.com/health/scoliosis#symptoms
• https://www.wikidoc.org/index.php/Scoliosis_epidemiology_and_demographics#:~:text=Scoliosis%20is%20the%20most%20common,5200%20per%20100%2C000%20individuals%20worldwide.

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