Thoracolumbar scoliosis is a type of scoliosis affecting the area where your upper and lower back meet, causing a curve in the spine. It can be treated with careful monitoring of the curve, a brace, or surgery.
Scoliosis is fairly common. The American Association of Neurological Surgeons estimates that 2–3% of people in the United States — which is approximately 6–9 million people — are affected.
Still, as mild scoliosis can be asymptomatic and subsequently go undiagnosed, that number could be higher.
Thoracolumbar scoliosis is one of the most common forms. An earlier study
Scoliosis can affect any of the three major sections of the spine. It’s known as thoracolumbar scoliosis when it affects the chest and mid-back area (thoracic spine) and the upper portion of the lower back (lumbar spine).
People with thoracolumbar scoliosis can experience pain, either due to the curve of the spine itself, compression of the nerves in the area, or both. You may also experience pain related to muscular fatigue because the muscles on one side are working harder to maintain balance.
There’s often also a bulge in the back, around the area where you might feel pain and asymmetry. You might also have an uneven waist or ribcage, uneven shoulders, notice that one shoulder blade is more visible than the other, or that your body leans to one side.
Some people with thoracolumbar scoliosis may also experience loss of height. You may also notice shortness of breath. Pressure on the abdomen may also make your stomach feel full even if you haven’t had anything to eat.
Still, not everybody with scoliosis experiences pain or other symptoms or pain — it can be asymptomatic.
There are three main types of scoliosis: idiopathic, congenital, and neuromuscular.
Congenital scoliosis occurs when the ribs or spine don’t form properly during fetal development, with the spinal curvature present from birth.
The process for diagnosing thoracolumbar scoliosis is the same as for diagnosing other types of scoliosis. A healthcare professional will likely recommend a physical exam and X-rays to confirm or make a diagnosis.
You may need to stand upright while they take X-rays of your front and side to measure the degree of the curve. The healthcare professional may ask you to bend over while they take more imaging. This would measure the curve’s flexibility.
Your clinician will diagnose scoliosis if the curve of your spine is greater than 10 degrees.
They might also assess you for spinal stenosis, which is the narrowing or compression of the spinal canal. If they think your scoliosis might affect your breathing, your clinician may recommend more testing.
A few different treatments for thoracolumbar scoliosis can help. The treatment that’s best for you can depend on your age, the location of the curve, the degree of the curve, and the likelihood of the curve progressing.
If the curve is between 10–25 degrees, your doctor may decide it’s best to monitor your scoliosis for the time being. They may recommend a brace if the curve is between 25–40 degrees.
Healthcare professionals typically recommend surgery if the curve is more than 40 degrees or if your symptoms are severe. For example, people who have difficulty breathing or standing upright for day-to-day activities may benefit.
The most common surgery is spinal fusion, which involves joining multiple vertebrae with a bone graft to make them a single unit. Your medical team may take the grafts from your body or a donor through a bone bank.
You’ll have rods in your back to help support the spine and keep it straight while the bones fuse together. This can help prevent the spine from curving again.
Scoliosis is a lifelong condition that’s often progressive. For many people, scoliosis worsens with age.
If you have thoracolumbar scoliosis, you may be able to manage it for many years with careful monitoring or physical therapy.
But if scoliosis is interfering with your quality of life, you might consider a more permanent intervention. Surgical correction of the spine can help alleviate pain and other scoliosis symptoms.
Adam England lives in the UK, and his work has appeared in a number of national and international publications. When he’s not working, he’s probably listening to live music.