One or both of the patients above has scoliosis.
Can you tell which one(s)?
If they both have scoliosis, which one do you think is worse?
The answer is given in the picture below.
In fact, the first patient has an 80 degree double curve scoliosis, and the other patient has a 41 degree thoracolumbar scoliosis.
This is a good example how looks can be deceiving, and that bug curves can sometimes be hidden, especially double curves in larger-frame patients. This emphasizes the benefits of careful scoliosis screening, including using the scoliometer and careful physical examination combined with appropriate ordering of standing X-Rays.
While some curves, especially R thoracic curves in thin patients, become fairly obvious on observation, this is not always true, depending on curve type.
As we have discussed earlier, it is always helpful to “catch” a curve when it is smaller, and then follow it over time.
It is clearly easier to fix the 41 degree curve, which I fixed today in 2 hours and 15 minutes with 450 cc blood loss.
The 80 degree double curve took almost 6 hours to fix, and required 2 units of blood, and 4 day length of stay, compared to the typical 2-night stay for the smaller curves. Both will end up doing well, but the curves can be fixed with less risk when identified and followed early and consistently.
Most patients and families prefer to know that they have scoliosis, and can follow it over time.
Looks can be deceiving, but careful evaluation and follow-up can lead to excellent outcomes with less risk.
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
http://www.heyclinic.com