Study evaluates treatments for scoliosis

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Carol Sorgen

People with scoliosis suffer from an abnormal side to side (or lateral) curvature of their spine. Rather than appearing straight when viewed from the back, their spine may appear shaped somewhat like an “S” or “C”.

Scoliosis is a common condition, usually experienced by children and adolescents. However, adults can also develop scoliosis, which may bring with it pain and sometimes visible deformity.

Dr. Charles Edwards II, medical director of the Maryland Spine Center at Mercy Medical Center in Baltimore, said that adults with scoliosis fit into two categories: those who developed the condition as adolescents, and those with adult onset (degenerative) scoliosis.

“As we age, the discs in our spine degenerate, which can cause the spine to tilt, much like the Leaning Tower of Pisa,” Edwards said.

Bulging discs, tilting bones and the formation of bone spurs not only lead to the development of back pain, but also put pressure on the nerves. When spinal nerves are compressed, people may feel pain, numbness or cramping in their legs.

Although paralysis is very uncommon with adult scoliosis, people tend to slow down and experience a reduced quality of life due to the increased pain.

Treatments make a difference

For Wendy Warren, the pain from scoliosis became so bad that she couldn’t even stand at the kitchen table to make a salad.

“I was in agony,” said the 65-year-old Howard County resident. Warren had suffered from back pain for years, but attributed it to the occupational hazard of being a nurse. “But it got progressively worse,” she said and nothing she tried helped — until she was referred to a health study being conducted by Edwards.

To determine which patients — like Warren — benefit from scoliosis treatment and what kind of treatment is most effective, the Maryland Spine Center is participating in a five-year, multi-site trial comparing the results of surgical and non-surgical treatment.

Launched in 2010, the study is funded by the National Institutes of Health and is the first of its kind to examine adult-onset spinal deformities.

Most of the research has historically focused on adolescents, Edwards said. “Unlike for kids, who still have some growth potential left, for adults the treatment is mostly driven by the patient’s symptoms,” he said. “It’s about quality of life rather than concern for correction.”

Two hundred patients have been studied so far. An additional 150 are being recruited at six sites around the country, including Mercy’s Spine Center.

Study offers choices

To be eligible for the study, participants must be 40 to 80 years of age and have a scoliosis curve greater than 30 degrees with the apex of the curve in the lumbar spine.

Selected participants will be followed for five years and will be asked to fill out periodic health questionnaires, complete a functional treadmill test, and have routine X-rays and regular physician office visits.

Study participants will be invited to choose one of three options in which to participate:

Option 1: Non-surgical treatment, which includes interventions such as injections, medication, physical therapy and exercise

Option 2: Surgical treatment, which involves relieving nerve pressure, straightening of the spine, and fusing several of the spine bones together

Option 3: Undecided course of treatment, from which participants randomly will be selected for either non-surgical or surgical treatments

The surgery usually requires a three- to five-day hospital stay, and is covered by Medicare or private health insurance. Some patients spend an additional week to 10 days in a rehabilitation facility.

“By two or three months, most individuals are back to all normal functions, except prolonged exercise, heavy lifting or forceful bending,” Edwards said of those undergoing surgery. “These functions return to normal in a three- to six-month time frame.”

For Warren, who had the surgery in April 2011, the pain relief was almost immediate. “I’m a whole new person now,” she said, adding that she’s back to walking four to five miles a day, and is currently loading her backpack with sandbags to get in even better shape for a planned backpacking trip this spring.

“I have a new lease on life,” she said.

Study participants will receive a cash payment to compensate them for time spent completing questionnaires and follow-up visits, whether or not they have surgery.

For more information about the adult scoliosis clinical trial or to find out if you are eligible to participate, contact Lisa Ford, PA, Maryland Spine Center Research Coordinator, at auntweesa2@yahoo.com, or by calling (410) 332-9077.