What is dextroscoliosis?
Dextroscoliosis is a type of scoliosis. Scoliosis is a deformity of the spine that results in a sideways curve of the spinal column. If the spine curves to the right, the condition is known as dextroscoliosis. If the spine curves to the left, the condition is called levoscoliosis. About 3 out of every 100 people have some type of curve to their spine.
Dextroscoliosis is the more common type of scoliosis. The right-sided curvature of the spine can cause the spinal column to appear in the shape of a “C” or an “S” instead of a straight line. It typically affects the middle to upper areas of the back known as the thoracic spine.
Scoliosis generally occurs in children aged 10 to 15 years, when they experience their growth spurt. However, it can occur at other ages if it’s caused by something else like a muscle disease.
Keep reading to learn more about the symptoms of dextroscoliosis, how it’s treated, and more.
What are the symptoms?
People who have dextroscoliosis may experience:
- uneven shoulders, with a difference in shoulder height
- shoulder blade prominence, with one shoulder blade protruding out farther than the other
- rib prominence, with the ribs on one side of the body protruding out more than the other side
- uneven waistline, with a difference in height between the two sides
- uneven hips, with a difference in height between the two sides
- a noticeable curve to the spine
- head tilt, with the head leaning more to one side
- body tilt, a leaning of the upper body to one side
For people with scoliosis who have severe curves, their curved spine may press on other organs and areas of their body.
This can cause severe symptoms such as:
- difficulty breathing and shortness of breath if the lung is compressed
- chest pain
- back pain
- leg pain
- changes and difficulties with urination or defecation
What causes dextroscoliosis?
Scoliosis can have different causes. The most common type of scoliosis is idiopathic scoliosis. With this type, there is no known cause. Idiopathic scoliosis occurs in 80 to 85 percent of all people with scoliosis.
Medical researchers suspect some people may have a genetic predisposition to developing idiopathic scoliosis. Thirty percent of the people who have this type also have family members with scoliosis.
The remaining 15 to 20 percent of people with scoliosis experience one of the following:
Congenital scoliosis: This type occurs during fetal development. It affects 1 in 10,000 births and can be accompanied by problems with heart and kidney function.
Degenerative scoliosis: This type can develop in older adults. It results from conditions such as arthritis, osteoporosis disk degeneration, ankylosing spondylosis, and vertebral compression fractures.
Miscellaneous: This can be caused by multiple things such as Ehlers-Danlos and Marfans syndromes, which are connective tissue disorders, tumors, and certain metabolic disorders, in addition to other diseases.
Who’s at risk?
Idiopathic scoliosis has no known cause, so there are no preventative measures that can be taken at this time. Some people appear to be genetically predisposed to developing this type of scoliosis.
How is dextroscoliosis diagnosed?
Dextroscoliosis, as with all types of scoliosis, is diagnosed by a doctor during a physical examination.
The exam generally includes:
- looking at your spine from the back
- checking for shoulder, waist, and hip height to see if both sides are even or uneven
- examining both sides of your rib cage to see if one side sticks out more than the other
- having you perform the Adam’s forward bending test, which involves bending forward with your feet together, knees straight, and arms dangling loose at the sides of your body
- taking X-rays of your spine so your doctor can see where the curve is located and determine how much of a curve exists
Treatment options include nonsurgical and surgical approaches. Your specific treatment plan will depend on:
- how severe your scoliosis is
- the location of the curve
- the risk of progression
- your age
If the curve is less than 25 degrees and not rapidly worsening, your doctor will take X-rays and possibly other imaging tests every 6 to 12 months to monitor your condition.
If your spinal curves are between 25 to 45 degrees, your doctor may recommend bracing or casting to help support your spine. This won’t correct a curve, but it can help to prevent curves from worsening.
Your doctor may recommend surgery if your curves are:
- worsening over time
- causing severe and obvious deformities
- resulting in additional complications, such as neurological or breathing problems
There are different surgical approaches, including:
Spinal fusion: In this procedure, the surgeon repositions the spinal bones that form the curve and fuses them together into one bone using a bone graft. The bone graft is placed between the vertebrae that form the curve.
Metal rod(s) or growing rod: This involves anchoring one or two metal rods to the spine above and below the area with the curve with wires, hooks, or screws. With the growing rod approach, the surgeon can later extend the rod with a minor surgical procedure.
Hemivertebra removal: This involves removing one portion of one vertebra to help lessen the severity of the curve. A metal implant may then be added.
Complications from scoliosis surgery can include:
- abnormal bleeding
- damage to one or more nerves
For mild scoliosis, there are generally no complications. Complications from having more severe curves with dextroscoliosis and scoliosis include:
- problems breathing if the curve causes a change to the shape of your chest and puts pressure on your lungs or lessens the amount of lung expansion for breathing
- chest pain from a deformity to the trunk
- bowel or bladder control problems if a curve is compressing spinal nerves leading to these organs or putting pressure on organs
- back or leg pain if a spinal curve is compressing spinal nerves
Children and teenagers who have spinal fusions for idiopathic scoliosis generally experience good outcomes with their spinal curves straightening out. Many can return to their normal activities approximately six to nine months after their surgery. There may be some limits to their spinal range of motion, so they’re typically advised against participating in full-contact activities and sports like football.
Children and teenagers who have idiopathic scoliosis and haven’t had surgery generally have no physical restrictions.
Congenital scoliosis that is diagnosed at an early age tends to be more severe, and the curve will most likely worsen as the child grows. These surgeries are usually done at an earlier age, so the child may end up with a shorter spine. Still, the outlook is generally good, and these children can typically lead normal lives.