Made up of many individual bones called vertebrae, the spine is joined together by muscles and ligaments. Flat, soft discs separate and cushion each vertebra from the next. Because the vertebrae are separate, the spine is flexible and can bend. Together the vertebrae, discs, muscles and ligaments make up the vertebral column or spine.
Different regions of the spine are named differently. The cervical spine refers to the neck, the thoracic spine to the chest, and the lumbar and sacral spines to the lower back.
Illustration on right shows the spine from the front and the side.
Normal Spine Curves
Just as the shapes of peoples' bodies differ, the normal spine varies in size and shape. You may have been told to stand up straight, but no one's spine is perfectly straight. A healthy spine has front-to-back curves. It is only when these curves become too large that they present a potential problem.
Abnormal Spine Curves
Spinal abnormalities are more common than you think. Many people are affected with some type of spine abnormality, and may not even be aware or need treatment.
Abnormal spinal curves can be the result of many different causes. Some children or adolescents may have a nerve or muscle disease (neuromuscular), injury or other illness that may have attributed to their spinal abnormality. Examples of neuromuscular injuries or illnesses include cerebral palsy, spina bifida and muscular dystrophy.
Some people are born with spinal defects that cause the spine to grow unevenly- referred to as congenital (present at birth). While in other cases, the spine may not grow as straight as it should without a known cause or means of prevention, which is known as idiopathic.
Examples of congenital and idiopathic abnormalities include scoliosis, kyphosis and lordosis, and Klippel-Feil Anomaly.
Whether your particular spinal conditional is congenital, idiopathic or neuromuscular related, the Orthopedic Center's Spinal Program provides comprehensive treatment including evaluation, diagnosis, consultation, and follow-up care.
Observation: Keeping Watch On Curves
Once an abnormal spine curve has been detected, it is important to monitor the curve. In many cases, a child's spinal condition may only require close monitoring during skeletal growth. Your physician will decide on your treatment plan and follow-up based upon your x-rays and physical exam.
If your curve shows significant worsening or is already greater than 30 degrees, and you are still growing, your physician may recommend a bracing program.
A scoliosis brace is designed especially for you and your particular curve. It works by holding your spine in a straighter position while you are growing to try and partly correct your curve or prevent it from increasing. A bracing program may help avoid surgery. Boston Children's Spinal Program offers the following bracing programs:
If surgery is necessary the orthopedic surgeons in the Spinal Program utilize the most advanced surgical methods for the correction of spinal deformities including:
Thoracoscopic anterior spinal surgery and instrumentation
Expansion thoracostomy and VEPTR (titanium rib) procedure
Dual posterior growing rods for early onset scoliosis
Hemivertebra and wedge resections for congenital scoliosis
Mono-segmental reduction and fusion for severe spondylolisthesis