What is Scoliosis & Spinal Deformity?
Scoliosis is an abnormal sideways curvature of the spine that can develop in adolescence or emerge in adulthood as discs and joints degenerate asymmetrically. Adult deformity can cause pain, imbalance, and progressive loss of function; adolescent curves are often painless but may progress as the child grows.
Treatment ranges from observation and bracing to complex reconstructive surgery, including spinal osteotomy for rigid deformity. Dr. Varma’s deformity practice emphasizes careful selection: operating only when the curve, symptoms, and progression truly warrant it, and restoring balance with the least extensive construct possible.
Signs and considerations
Why it happens
Adolescent scoliosis is usually idiopathic — a growth-related curvature with a genetic component. Adult deformity arises either from an untreated adolescent curve or de novo, as discs and facets degenerate asymmetrically and the spine slowly buckles out of balance.
How it is diagnosed
Full-length standing X-rays measure the curve (Cobb angle) and global balance; MRI evaluates the nerves; CT assesses bone quality. In adolescents, growth remaining is the key variable; in adults, the driver is pain, imbalance, and progression documented on serial imaging.
Treatment options
Adolescents: observation for small curves, bracing during growth for moderate ones, surgery for progressive curves beyond ~45–50°. Adults: therapy and pain management first; surgery — from targeted decompression to full reconstruction with osteotomy — is reserved for progressive deformity that limits life despite conservative care.
