Understanding Scoliosis: From Detection To Treatment

KUALA LUMPUR, June 24 (Bernama) -- A healthy spine should appear straight, and when it begins to curve sideways like the letter “S” or “C”, it could be a sign of scoliosis, a condition that often goes unnoticed until it becomes more serious.

According to spine surgeon Dr Saw Lim Beng from Sunway Medical Centre, Sunway City, scoliosis is a condition involving an abnormal sideways curvature of the spine, often accompanied by rotation.

“Unlike a normal, straight spine, scoliosis causes uneven shoulders, a tilted body and a bulging rib cage or hump at the loin, usually on one side, leading to physical imbalance,” he told Bernama recently.

Dr Saw emphasised the importance of recognising early signs of scoliosis, like uneven shoulders or asymmetrical pelvic level, especially when a child walks, and noted that a 2017 publication found scoliosis affects two or three per cent of Malaysia’s population, with less than 0.1 per cent being severe cases.

“Most cases are relatively mild, with curvatures ranging between 10 and 20 degrees, especially in growing children,” he added.

Dr Saw explains that scoliosis in children is most commonly idiopathic, making up about 95 per cent of cases with no known cause. Other types include congenital scoliosis (present at birth), neuromuscular scoliosis (linked to conditions such as cerebral palsy), and degenerative scoliosis (common in older adults due to spinal degeneration).

He said that the best time for children to undergo spine screening is during adolescence, typically between the ages of 10 and 15, as this is when scoliosis is most likely to develop.

He also noted that scoliosis can often be detected through a clinical examination, such as the Adam’s Forward Bending Test, where doctors observe the asymmetrical rib cage as the child bends forward.

Dr Saw explains that treatment approaches vary depending on the severity of the curve and the patients’ ages.

“For curves less than 20 degrees, observation is usually sufficient for both growing children and adults. When the curve ranges between 20 and 40 degrees, growing children are typically prescribed a brace and monitored closely, while adults may be observed at two- to three-year intervals.

 “For curvatures exceeding 45 degrees, surgery may be recommended for both children and adults,” he said.

Although scoliosis surgery has proven effective, Dr Saw cautioned that it carries potential risks such as nerve injury, which could lead to paralysis. Other complications include infections and spinal imbalance after surgery.

Dr Saw highlighted that new technologies are making spinal surgery safer and more precise, such as the AiBLE™ Spine Surgical Suite - the first of its kind in Southeast Asia - a system that combines an advanced imaging system, navigation guidance, robotic arm and artificial intelligence.

“With advancements in technology, the latest spine surgical systems, such as the AiBLE™ Spine Surgical Suite, are transforming how we perform spinal surgeries, allowing for greater precision, enhanced surgeons’ intraoperative control, and a more efficient process for both surgeons and patients,” he added.

For severe cases requiring surgery, he said recent advancements in surgical techniques have significantly improved outcomes, safety and recovery.

“Robotic-assisted procedures, real-time navigation systems, and patient-specific rods have helped reduce risks and enhance precision. Surgery that once took up to eight hours can now be completed in just two to four hours, with most patients discharged by day one or two,” he added.

Dr Saw also stressed the importance of maintaining good spinal alignment to prevent long-term damage to the spine and joints, noting that poor posture and weak core muscles could increase the risk of spinal issues, especially during daily activities such as lifting or bending.

He advised individuals, including parents and working adults, who suspect symptoms of spinal problems to consult a general practitioner for early diagnosis.

In conjunction with Scoliosis Awareness Month in June, Dr Saw encouraged individuals with scoliosis or those who have undergone spinal surgery to attend awareness programmes to better understand the condition, its aftercare and available treatment options.

-- BERNAMA

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