Interview with Sunway Medical Damansara, Dr Deepak and Dr Tan Jin Aun .— SAMUEL ONG/The Star
MOST of us expect our spine to be straight when viewed from behind – but for some, that’s not the case.
Consultant orthopaedic surgeon (spine surgery and interventional pain management) Dr Deepak Ajit Singh explains that scoliosis is a condition where the spine curves sideways.
“It can be a single curve shaped like a ‘C’, or a double curve like an ‘S’,” he says.
Consultant orthopaedic and spine surgeon Dr Tan Jin Aun adds: “Any curvature exceeding 10° is considered scoliosis.
“The curve usually becomes visible once it reaches 20° to 30°, often with a slight rotation of the vertebrae.”
In most cases, the cause remains a mystery – a form known as idiopathic scoliosis.
Others stem from congenital abnormalities, neuromuscular disorders or degenerative changes as we age.
“Many people confuse congenital and idiopathic scoliosis,” clarifies Dr Tan. “Congenital scoliosis develops in the womb, while idiopathic scoliosis develops after birth with no clear reason.”
When and why it happens
Scoliosis can affect anyone, but it most commonly appears during the growth spurt just before puberty – typically between ages 10 and 15.
“About 80% of cases occur during this phase,” says Dr Deepak.
“Even though scoliosis affects roughly 3% of the population, only about 0.5% will ever need treatment.”
Mild scoliosis often goes un- noticed. “Once the curve reaches 30°, it becomes obvious. At 40° or more, treatment is usually necessary,” he adds.
Early detection makes all the difference.
“Malaysia has been conducting school screenings for scoliosis since the late 1990s, which has helped us identify and manage cases earlier,” says Dr Tan.
Interestingly, Dr Deepak’s Master’s thesis was a part of this nationwide effort.
“We screened 10,000 schoolchildren in Kuala Langat District back in the ‘90s to get local data on scoliosis, and that study eventually influenced the national school screening programme,” he recalls.
Because scoliosis develops slowly, it often goes unnoticed until physical changes appear.
“Look for uneven shoulders or hips, or clothes that don’t hang evenly,” says Dr Tan.
“Children rarely feel pain, but if they do, it’s important to rule out other causes, like spinal tumours.”
Severe cases, however, can cause more than just cosmetic issues. “Large curves can lead to back pain, muscle imbalance, even breathing difficulties – and can affect self-esteem,” says Dr Deepak.
Diagnosis and treatment options
Diagnosis begins with a physical examination and X-rays to measure the degree of curvature – the deciding factor in treatment planning.
“Treatment depends on the curve’s size, the patient’s age and how fast it’s progressing,” explains Dr Tan.
“In adolescents, we monitor their growth closely. Girls tend to develop progressive curves more often than boys. If the curve is below 45° when skeletal growth is complete, it usually won’t worsen and doesn’t need surgery.”
However, curves exceeding 45° at skeletal maturity often require surgical correction.
“Even after growth stops, these curves can continue worsening – by about one degree per year,” says Dr Tan.
“Surgery isn’t cosmetic; it prevents the curve from progressing and causing complications later.”
Modern scoliosis surgery involves spinal fusion using metal rods and screws to straighten and stabilise the spine.
“With today’s technology and techniques, scoliosis surgery is much safer, with better correction and faster recovery,” reassures Dr Deepak. “Safety remains our top priority.”
For older adults, the treatment goal may differ. “Instead of correcting the curve, we focus more on relieving pain and maintaining mobility,” he says.
Living with scoliosis
Most people with scoliosis can lead full, active lives, especially with early diagnosis and proper care.
“Parents shouldn’t panic,” advises Dr Deepak. “Focus on your child’s well-being and follow-up appointments. The vast majority will not need surgery.”
Many ask about braces – the corset-like devices worn for several hours daily.
“Bracing doesn’t correct the curve,” Dr Deepak clarifies.
“It helps control it and improves balance, but it doesn’t stop progression.”
Physical therapy can help maintain muscle strength and flexibility.
“Avoid sports that involve a lot of twisting, like tennis or golf,” he suggests. “Swimming is a good alternative.”
Emotional well-being matters too. “A diagnosis can be worrying, especially for teens, but with reassurance and the right guidance, most cases are manageable,” say both specialists.
