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Scoliosis and Other Spine Issues --Trends and Treatments

Dr. Eldin Karaikovic June 06, 2011 1:00 PM This chat has ended. Thank you for participating.
Catherine (Moderator) - 12:46 PM:
Welcome! Today’s chat: Scoliosis and Other Spine Issues – Trends and Treatements will begin shortly. Please start submitting your questions and Dr. Eldin Karaikovic will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the Orthopaedic Section to obtain more information about scoliosis. We will do our best to answer all of your questions, but because this is such a popular chat, the physician may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.

Catherine (Moderator) - 1:06 PM:
The chat will begin a few minutes late. Sorry for the inconvience.

Barbara (Glenview, IL) - 1:13 PM:
My orthopedist says my severe hip and leg pain is caused by scoliosis. Would a shot of cortisone help? Acupuncture? Could anything else be done to ease the pain?

Dr. Eldin Karaikovic (NorthShore):
Dear Barbara, Scoliosis can cause spinal stenosis which compresses the nerves in the spinal canal and cause sciatica. This sciatica can be then interpreted as hip or leg pain since the nerve runs from the spinal into the foot. A cortisone shot might help in up to 50% of patients. Acupuncture is an alternative treatment and there is no scientific data that supports it but one can try it. Usual treatment is physical therapy with medication, followed with a cortisone shot (epidural steroid injection) and finally with a surgery. Best regards Eldin Karaikovic, MD, PhD

Catherine (Moderator) - 1:16 PM:
Welcome! June is Scoliosis Awareness Month. I am Eldin Karaikovic MD, PhD, a senior orthopaedic spine surgeon at the Northshore Department of Orthopaedic Surgery. I am grateful for your participation and interest. The chat time and space is limited but I will do my best to answer as many of your questions as possible. Please note that due to shortage of time some of the answers I will provide will not cover in depth your questions or topics you are interested in. Therefore, for further in-depth explanations please contact my office at 847-570-2820. Your understanding is greatly appreciated.

Melissa (Northbrook, IL) - 1:17 PM:
My daughter (age 10) was diagnosed with a 13% curvature. I am curious about this newly approved blood test that I hear about. Can you talk about it.

Dr. Eldin Karaikovic (NorthShore):
Dear Melissa, you are right. The genetic testing started at the beginning of this year. It is available in our institution as well. It is a test to predict possible progression of the curvature. It helps reduce the amount of radiation and gives us some input how serious the curvature is. Your daughter is a good candidate for that test since her curvature is only 13 degrees. The test is painless (we need a spit-saliva- only). I think you and your daughter should take an advantage of this new technology. The only downside is that it is at this moment approved only for Caucasians. Best regards Eldin Karaikovic, MD, PhD 847-570-2820

Tom (Wilmette, IL) - 1:25 PM:
Can families be genetically predisposed to scoliosis? Is it hereditary?

Dr. Eldin Karaikovic (NorthShore):
Dear Tom, There is more and more evidence in the literature that there is some genetic predisposition for scoliosis although it has not been completely confirmed and a single "scoliosis" gene identified. We know that scoliosis runs in families, but a clear way of transmission has not be established. Girls are more affected than boys. There is a new genetic test which was introduced recently which can show how likely it is that one's curve will progress. I certainly will be on guard if anybody in my family has/had scoliosis (parents, grandparents, aunts etc). Girls and boys with scoliosis have higher likelihood to have children with scoliosis. Best regards Eldin E. Karaikovic, MD, PhD 847-570-2820

Jim (Northbrook, IL) - 1:36 PM:
When I was a kid, I had a friend who had to wear a brace because she had scoliosis. It looked rather cumbersome as I recall. How has the technology improved to correct spine curviture?

Dr. Eldin Karaikovic (NorthShore):
Dear Jim Luckily we did some adjustments to braces used for scoliosis in the past. I must say we had to do adjustments because kids today do not want to wear those cumbersome metallic braces that looked like cages any more. The braces now are much lighter, made of plastic and do not include the neck and chin as they did in the past. These braces are made by a computerized machine that creates a brace based on a patient's x-ray. We therefore get a brace that uniquely fits a certain patient. Best regards Eldin E. Karaikovic, MD, PhD 847-570-2820

Bob (Mount Prospect, Illinois) - 1:40 PM:
I have two grandchildren (ages 6 and 8)and I'm concerned about the possibility of them having scoliosis since extended family had it years ago. Your video on the website about this new DNA marker test has peaked my interest. Could you provide some more insight into the test please?

Dr. Eldin Karaikovic (NorthShore):
Dear Bob, I am glad you are worried about your grandchildren because you are right. They have a higher risk of development of scoliosis. It usually starts in adolescents, so make sure that your physician knows about this as he/she can test them. Most of curvatures are discovered on a plain doctor's exam. The genetic test is used only if children are over age 9 years and have a verified curvature (on xrays) of > 10 degrees. Therefore, for now it is enough only to be followed with their pediatrician. Also you can examine their backs for any asymmetry and/or curvature Best regards, Eldin Karaikovic, MD, PhD 847-570-2820

Barbara (Glenview, IL) - 1:44 PM:
What is "progressive" scoliosis? How does my doctor know whether or not mine is "progressive"?

Dr. Eldin Karaikovic (NorthShore):
Dear Barbara, "progressive" means that the curvature of the spine is getting worse (getting "more curved"). One can know if one's curvature is progressive only if he/she has radiographs of the spine from different times so by measuring curvatures can see that they are getting worse (have more degrees of angulation). Best regards Eldin Karaikovic, MD, PhD 847-570-2825

Leslie (Evanston, IL`) - 1:47 PM:
Can scoliosis be prevented?

Dr. Eldin Karaikovic (NorthShore):
Dear Leslie, The onset of scoliosis unfortunately cannot be prevented, but its course can be altered (improved) with early recognition and treatment. That is why it is important that children (especially with a family history of scoliosis) are checked regularly by their pediatrician and family members. Best regards Eldin Karaikovic, MD, PhD 847-570-2825

Melissa (Northbrook, IL) - 1:50 PM:
My 10yo was diagnosed with scoliosis and I have heard about a new blood test that can predict severity or whether bracing or surgery may be necessary. Can you please discuss this test and what it shows?

Dr. Eldin Karaikovic (NorthShore):
Dear Melissa, It appears that this test is very useful. It predicts that one curvature has higher or lower chances of progression. This reduces the amount of x-rays needed in a regular follow up, as well the amount of radiation that the child receives. Our institution has this test available. The test is indicated for children from 9-13 years of age and curvature from 10-25 degrees. The only limitation is that it is approved only for Caucasians at this time. You daughter (or son) is a good candidate. The test is painless (we only need saliva - spit) Best regards Eldin Karaikovic, MD, PhD 847-570-2825

Catherine (Moderator) - 1:53 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.

Barbara (Glenview, IL) - 1:57 PM:
Is the DNA test for progressive scoliosis only for children?

Dr. Eldin Karaikovic (NorthShore):
Dear Barbara, Yes, the test is only done for children from 9-13 years of age. Best regards Eldin Karaikovic, MD, PhD 8470-570-2825

Denise (Evanston, IL`) - 1:58 PM:
How do I know if my child needs surgery?

Dr. Eldin Karaikovic (NorthShore):
Dear Denise, the indication for surgery is done based on a degree of curvatures (usually over 40-45 degrees) and their progression. The curvatures that progress rapidly, in spite of bracing, might need to be surgically treated. The younger the child and the larger the curvature, the likelihood of a necessity for a surgical treatment is higher. Best regards Eldin E. Karaikovic, MD, PhD 847-570-2825

Catherine (Moderator) - 2:00 PM:
Thank you again for participating in our chat today. For more information please visit our Scoliosis pages.

Also, a transcript of this chat will be available shortly.
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