What is Adolescent Idiopathic Scoliosis?
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. It helps to break the name into its three sections:
What is Adult Scoliosis?
Adult scoliosis is an abnormal curve of the spine in a patient who is skeletally mature (finished growing). The spine can curve to the right or to the left.
What is Duchenne Muscular Dystrophy?
Duchenne Muscular Dystrophy (DMD) is one of the most common types of muscular dystrophy. It is a gene-related disorder that makes muscles unable to produce a protein called dystrophin.
When Spine Surgery for Duchenne Muscular Dystrophy is Recommended
- If Dr. Bridwell believes that the patient’s spinal curve will get worse and cause other health problems: For DMD patients with scoliosis, curve progression is almost certain, particularly if the curve(s) is/are greater than 30º.
- If the patient is young enough: As DMD patients get older and their muscles fail more, it’s more difficult for them to endure the surgery. Most patients are treated between the ages of 11 and 18.
How Dr. Bridwell Treats Duchenne Muscular Dystrophy
Posterior Spinal Fusion with Instrumentation: Dr. Bridwell will perform the surgery from the back of the spine; that’s called a posterior approach. He will correct the curve.
What is Congenital Scoliosis?
Congenital means “present at birth”. So congenital scoliosis is the result of malformation of part of the spine during pregnancy. Scoliosis can cause the spine to curve to the right or to the left.
When Spine Surgery for Congenital Scoliosis is Necessary
- If the curve is rapidly getting worse
How Dr. Bridwell Treats Congenital Scoliosis
Depending on the specific case, Dr. Bridwell uses one of two surgical options to treat congenital scoliosis. After thoroughly studying the case, Dr. Bridwell will make his best recommendation, and he will completely explain the surgical procedure.
Non-surgical Treatments for Adolescent Idiopathic Scoliosis
- For small curves (15º-20º): Observation over time to see if the curve gets worse
- For bigger curves (20º-40º): Bracing to try to stop the curve from getting worse
When Spine Surgery for AIS is Necessary
- If the curve is bigger than 40º or 45º
Please note: Spine surgery for AIS is an effective method to correct the curve and avoid greater deformity.
How Dr. Bridwell Treats AIS
AIS Thoracic Curve
Posterior Spinal Fusion with Instrumentation: Dr. Bridwell will perform the surgery from the back of the spine; that’s called a posterior approach.
What is Cerebral Palsy?
Cerebral palsy (CP) is a group of disorders characterized by muscle stiffness (also called spasticity), making everyday activities such as walking, talking, eating, and holding objects difficult.
When Spine Surgery for CP is Recommended
- If Dr. Bridwell believes that the patient’s spinal curve will get worse and cause other health problems
- If the patient has poor spinal balance and alignment, making it difficult to stand or sit comfortably
How Dr. Bridwell Treats Cerebral Palsy
Posterior Spinal Fusion with Instrumentation: Dr. Bridwell will perform the surgery from the back of the spine; that’s called a posterior approach. He will correct the curve.
When Spine Surgery for Adult Scoliosis is Recommended
- If non-surgical treatments do not relieve pain
- If the curve is getting worse
- If the curve is bigger than 45º—and especially if the curve is large enough to reduce lung function and accelerate degenerative changes in the spine
Please note: It is common to have spine surgery for adult scoliosis in Dr. Bridwell’s practice. The goal is to relieve pain, prevent the curve from getting worse, and achieve some correction of the curve.
How Dr. Bridwell Treats Adult Scoliosis
Adult Scoliosis Thoracic Curves
Posterior Spinal Fusion with Instrumentation: Dr.
What is Lumbar Spinal Stenosis?
Spinal stenosis is a narrowing of the spinal canal in the spine.
What Spine Surgery for Lumbar Spinal Stenosis is Recommended
- If non-surgical treatments don't relieve pain
- If pain radiates down a leg (a symptom called radiculopathy)
- If the patient is losing sensation or motor strength in the legs
- If the patient is losing bowel or bladder control
How Dr. Bridwell Treats Spinal Stenosis
Posterior Decompression: Dr. Bridwell will perform the surgery from the back of the spine; that is called a posterior approach.
What is Spinal Muscular Atrophy?
Spinal Muscular Atrophy (SMA) is a type of motor neuron disease caused by a missing or mutated gene on chromosome 5 called SMN1.
When Spine Surgery for Spinal Muscular Atrophy is Recommended
- If Dr. Bridwell believes the patient’s spinal curve will get worse and cause other health problems
- If the patient has poor spinal balance and alignment
- If the patient is young enough: As SMA patients get older and their muscles fail more, it is more difficult for them to endure the surgery, particularly because of respiratory difficulties.
How Dr. Bridwell Treats Spinal Muscular Atrophy
Posterior Spinal Fusion with Instrumentation: Dr. Bridwell will perform the surgery from the back of the spine; that’s called a posterior approach. He will correct the curve.
What is Kyphosis?
The spine is supposed to have some curves from the side; they help it efficiently carry weight and absorb the body's movements.
What Spine Surgery for Kyphosis is Recommended
- If non-surgical treatments do not stop the curve from getting worse
- If it is a mid-back curve (thoracic curve) that is progressing and bigger than 80º-90º
- If it is a mid-back to low back curve (thoracolumbar curve) that is progressing and bigger than 60º-70º
- If there is disabling back pain
How Dr. Bridwell Treats Kyphosis
Scheuermann's Kyphosis
Posterior Spinal Fusion with Instrumentation: Dr.
What is Isthmic Spondylolisthesis?
Spondylolisthesis is when one vertebra (the bones that make up the spine) slips forward over the vertebra below it.
When Spine Surgery for Isthmic Spondylolisthesis is Recommended
- If non-surgical treatments do not relieve pain
- If the slip is Grade III or above
- If the slip is causing nerve damage
- If there is disabling pain
How Dr. Bridwell Treats Isthmic Spondylolisthesis
Posterior Decompression: Dr. Bridwell will perform the surgery from the back of the spine; that is called a posterior approach.
What is Degenerative Spondylolisthesis?
Spondylolisthesis is when one vertebra slips forward over the vertebra below it. Degenerative spondylolisthesis is the result of aging and wear and tear on the spine.
When Spine Surgery for Degenerative Spondylolisthesis is Recommended
- If non-surgical treatments do not relieve back and leg pain
- If the slip is progressing (getting worse)
- If the slip is causing nerve damage
How Dr. Bridwell Treats Degenerative Spondylolisthesis
Posterior Decompression: Dr. Bridwell will perform the surgery from the back of the spine; that is called a posterior approach.
What is High-grade Spondylolisthesis?
Spondylolisthesis is when one vertebra slips forward over the vertebra below it. High-grade spondylolisthesis is when the vertebra has slipped forward significantly.
When Spine Surgery for High-grade Spondylolisthesis is Recommended
- If non-surgical treatments do not relieve back and leg pain
- If the slip is progressing (getting worse)
- If the slip is causing nerve damage
How Dr. Bridwell Treats High-grade Spondylolisthesis
Posterior Decompression: Dr. Bridwell will perform the surgery from the back of the spine; that is called a posterior approach.
What is Infantile Idiopathic Scoliosis?
Infantile idiopathic scoliosis is a form of scoliosis. It helps to break the name into its three sections:
Non-surgical Treatments for Infantile Idiopathic Scoliosis
- Bracing: In an effort to stop the curve from progressing, Dr. Bridwell may have the patient wear a brace.
- Dr. Bridwell has worked with the same orthotist (a specialist who makes braces) since 1984. The orthotist is on-site at Barnes-Jewish and St. Louis Children’s Hospitals and comes to all patient visits to check on how the patient is doing with the brace. The orthotist makes repairs or modifications to the brace during the office visit.
- Dr. Bridwell uses [info to come]
When Spine Surgery for Infantile Idiopathic Scoliosis is Recommended
- If the curve gets worse despite bracing
Please note: Spine surgery for infantile idiopathic scoliosis is an effective method to correct the curve and avoid greater deformity.
How Dr. Bridwell Treats Infantile Idiopathic Scoliosis
Growing Rod Technique: If a patient is under the age of 10, Dr. Bridwell generally doesn’t do a long fusion because the spine is still growing so much. He prefers to use a growing rod technique. In that, he surgically places instrumentation and implants into the spine that will help the spine grow straighter. Periodically, he will lengthen and change those implants so that the spine can continue to grow.
What is Juvenile Idiopathic Scoliosis?
Juvenile idiopathic scoliosis is a form of scoliosis.
Non-surgical Treatments for Juvenile Idiopathic Scoliosis
- Bracing: In an effort to stop the curve from progressing, Dr. Bridwell may have the patient wear a brace.
- Dr. Bridwell has worked with the same orthotist (a specialist who makes braces) since 1984. The orthotist is on-site at Barnes-Jewish and St. Louis Children’s Hospitals and comes to all patient visits to check on how the patient is doing with the brace. The orthotist makes repairs or modifications to the brace during the office visit.
- Dr. Bridwell uses [info to come]
When Spine Surgery for Juvenile Idiopathic Scoliosis is Recommended
- If the curve gets worse despite bracing
Please note: Spine surgery for juvenile idiopathic scoliosis is an effective method to correct the curve and avoid greater deformity.
How Dr. Bridwell Treats Juvenile Idiopathic Scoliosis
Growing Rod Technique: If a patient is under the age of 10, Dr. Bridwell generally doesn’t do a long fusion because the spine is still growing so much. He prefers to use a growing rod technique. In that, he surgically places instrumentation and implants into the spine that will help the spine grow straighter. Periodically, he will lengthen and change those implants so that the spine can continue to grow.
