Q&A with Dr. James Eule

• What is scoliosis?

  Scoliosis is the medical term used to describe a spine that is curved more than 10 degrees to the right or left of straight when viewed from the rear. Depending on the extent of the curvature, the spine may show an s-shaped or c-shaped curve when viewed from the rear.It is also possible for curvature to impact the spine in the sagittal plane (from the front or back of the spine). Additional physical signs that may alert a provider to a diagnosis of scoliosis include uneven hips, leg or arm length discrepancies, a prominent shoulder blade, uneven looking ribs or uneven musculature on one side of the spine.
  

  Scoliosis may be congenital (vertebral anomalies that develop in the fetus and are present at birth) or idiopathic (the cause is unknown but the spine starts off straight and curves at some point during childhood, adolescence or adulthood.) Certain neuromuscular conditions such as spina bifida, cerebral palsy, atrophy of spinal muscles or physical trauma may also cause scoliosis and in these cases the condition is referred to as secondary scoliosis.The condition often presents or worsens during the adolescent growth spurt and is more common in females than in males.

  The most common form of scoliosis is late-onset idiopathic scoliosis, which is self-limiting and does not severely impact physical function.The rarer forms may be associated with serious complications that include reduced lung capacity, increased pressure on the heart and physical limitations.

• Why should people be aware of the condition?

  Early detection and proper diagnosis of scoliosis has a very positive effect on the outcome of the condition. All curves have a risk for progression, particularly during the rapid growth spurt that occurs during puberty. The goal of early detection and treatment is to keep the curvature as small as possible until skeletal growth is completed. Detecting and treating small spinal curvatures with less invasive approaches, early on, can reduce the incidence of orthopedic surgeries required to treat severe spinal curvatures. This is why there are school screening programs in all 50 states.

• What are the symptoms of scoliosis?

  A person with scoliosis will have a lateral (side-to-side) curvature of the spine that is visible on examination of the spine. Children and teens rarely experience symptoms of scoliosis. At any age, if the degree of curvature is small there may not be any symptoms other than a slightly crooked looking spine. As the degree of curvature increases symptoms may include: 
  

  • A prominent shoulder blade
  • Uneven looking ribs or musculature on one side of the spine
  • Uneven hips or shoulders
  • Leg or arm length discrepancies
  • One shoulder appearing higher than the other
  • An uneven looking waist

  Back pain is not typically caused by scoliosis but in severe cases there may be back pain and pressure on the lungs may cause difficulty breathing.

• If someone suspects they have scoliosis, what should they do?

  If you suspect that you or your child has scoliosis consult your healthcare provider.

• What’s involved in a screening — or pre-screening?

  Your provider may ask you some questions including:
  

  • When did you first notice a problem?
  • Are you experiencing any pain?
  • Are you experiencing any difficulty breathing?
  • Is there a family history of scoliosis?
  • If the patient is a child, has the child grown rapidly during the past six months?

  Initial screening is very straightforward and non-invasive; there are no needles and no pain. You’ll be asked to bend forward from the waist with your arms hanging loosely. Your provider will examine your spine to see if it is abnormally curved or if one side of your rib cage is more prominent than the other. You may also be asked to perform a simple neurological test to establish if you have any muscle weakness, numbness or abnormal reflexes.

• What are the treatment options?

  If your provider confirms or suspects that scoliosis is present, you will be referred to an orthopedic specialist for further diagnostic procedures and any necessary treatment. These may include observation, bracing, or surgery depending on the curve type and severity.

• Given the concern over lifetime radiation exposure, are there ways to diagnose and/or treat children without exposing them to radiation?

  Screenings can be done by the primary care provider, initially without the use of x-rays. If an x-ray is warranted, parents can take heart that today’s new x-ray technology uses less radiation than you’d receive taking a flight from Alaska to Hawaii.
  

• What was your role in creating the governor’s proclamation?

  It is a goal of the Scoliosis Research Society to have June become Scoliosis Awareness Month in all 50 states. As an SRS diplomat and someone who treats Alaskan scoliosis patients every year — I was more than happy to initiate the process with a letter to Governor Parnell.

• What’s the #1 thing you’d like to communicate to folks about scoliosis?

  Early recognition and intervention is the only effective treatment to prevent the progression and the need for surgery. I hope parents take this to heart and get their kids screened.