Spinal deformities strike without notice

In the last two years, doctors at Medcare have treated over 200 patients with varying degrees of spinal abnormalities.

A routine check-up in school last year in February saved a young girl from further complications when she was found to be suffering from severe spinal deformity.
The girl was 12 at the time when a diagnosis showed that she had silently developed scoliosis, a curvature of the spine that could in future hamper her growth and cause other complications.
"With the discovery was made, we were devastated because she never complained of any pain," said T.H, the father.
By that time, the curvature of the spine was at 18 per cent but over the next six months, it rapidly rose to 38 per cent.
"We panicked but searched all options in Dubai and abroad and finally settled for Medcare," he told Khaleej Times.
Six screws were fit into the back of the young girl to hold her spine in place after an eight hour long surgery done in November last year.
"During all this time, we were kept informed that she was doing well and we waited for her to regain consciousness," said T.H.
With three days of the surgery, the girl was up and walking and today even attends school for minimal hours.
"The curvature is less than 12 per cent now. Though she still has to avoid some things such as swimming, she is fine."
In the last two years, doctors at Medcare have treated over 200 patients with varying degrees of spinal abnormalities. In many cases, the diagnosis was delayed due to lack of awareness and information, with experts linking the start of the condition to adolescence.
Recognising the need to prevent, detect and raise awareness on common, yet little known about spinal deformities affecting people in the UAE, leading neuro spinal experts are implementing screening programmes for school children, to facilitate early diagnosis and treatment.
"Not many people realise that they have scoliosis or kyphosis, until the curve in the spine gets severe. In this region, the problem often goes undetected due to loose clothing worn by both men and women, concealing any unnatural curve," said Dr Nicandro Figueiredo, spinal neurosurgeon, Medcare Orthopaedics and Spine Hospital.
Recognising early symptoms is essential to enable proper assessment and treatment, while minimising risk of further progression, and undesired consequences for the patient.
"As the condition starts in adolescence and teenage years, we believe school screening for early detection of spinal deformities can prevent back problems and long-term degeneration. This test should be included in the annual health check programmes for children in all schools," he added.
The School Screening Programme for Spinal Deformity (SSPSS) aims to offer a fast, free of charge, and through screening for spinal deformities among school children in the UAE. These are being undertaken for boys and girls (10-14-years-old), to ensure timely detection and refer diagnosed cases for a more detailed assessment in a specialised centre. The team will be reaching out to over 100 students in two schools.  To complement the effort, school nurses and parents will also be educated about the spinal conditions that can affect children.
Prevention of severe scoliosis is a major commitment of physicians caring for spinal deformities. Studies have established that non-operative treatment with bracing and exercises may reduce the need for a surgery. To be effective, these treatments need to be applied to smaller back curves prior to skeletal maturity in children.
"Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of Scoliosis," said Dr Khaled Mabruk Faraj, senior consultant orthopedic and spine surgeon.
If the deformity is severe or still progresses, the child can be referred to the surgery at an appropriate phase of the deformity, with better chance of achieving success of the treatment.
Screening examinations for spine deformities involve various techniques including a visual examination, a physical examination, scoliometer reading, and surface topographic measures during an annual health services examination.
Types of spinal deformity

> Scoliosis and hyper kyphosis are the most common types of spinal deformity. Scoliosis involves a sideways curvature of the spine that occurs most often during the growth spurt in children just before hitting puberty. Kyphosis is a forward rounding of the back. Some rounding is normal, but the term 'kyphosis' refers to an exaggerated rounding of the back
> Mild scoliosis (10-25°) usually does not cause any harm, but those cases which progress without treatment can affect the internal organs causing significant spinal problems. They also have a negative psychological and cosmetic impact on a patient. Curve progression is related to the age of the child and the magnitude of the deformity. The most common problem associated with scoliosis is pain, usually more in the lumbar (lower spine) than in the thoracic (upper spine)
> Adolescent idiopathic scoliosis (AIS) involves abnormal sideways curving of the spine. Approximately three per cent of children under the age of 16 years are affected with the condition and it has a genetic predisposition
> If left untreated, progression of the disorder can lead to serious problems in adulthood such as breathing difficulties, chronic back pain and physical changes including uneven shoulders, prominent ribs, uneven hips, and a shift of the waist and trunk to the side
Screening for school students
The School Screening Programme for Spinal Deformity (SSPSS) aims to offer a fast, free of charge, and through screening for spinal deformities among school children in the UAE. These are being undertaken for boys and girls (10-14-years-old), to ensure timely detection and refer diagnosed cases for a more detailed assessment in a specialised centre. The team will be reaching out to over 100 students in two schools.
asmaalizain@khaleejtimes.com