SGH sees more cases of scoliosis with greater awareness

The incidence of scoliosis in Singapore looks to have stayed the same overall, but one hospital has seen more adults with the condition.

"In general, the incidence of scoliosis here is about 2.3 per cent and this appears to be the same in the last decade," said Associate Professor Gabriel Liu, head of the University Spine Centre at National University Hospital (NUH).

The centre sees about 4,500 to 5,000 cases of scoliosis a year. The condition is about seven times more common in girls than in boys, he said.

Scoliosis is a deformity of the spine, where the spine curves laterally, forming an "S" shape.

At Singapore General Hospital, there was an 8 per cent increase in adult scoliosis patients from 2016 to 2017. On average, SGH performs around 20 surgeries a year for adolescents and 180 surgeries on adult degenerative conditions for scoliosis.

"The number of scoliosis X-rays done in SGH has doubled in the past two years. This reflects increased awareness of patients, as well as doctors, about the condition," said Dr Reuben Soh, a consultant at the department of orthopaedic surgery at SGH.

The most common form of scoliosis is adolescent idiopathic scoliosis, affecting those between 10 and 18 years old.

Some signs of the condition include having an S-shaped curve in the back when standing, curving of the body to one side when seen from the front or back, one shoulder appearing higher than the other, and a tilt in the waistline.

If the spinal curve is between 25 and 40 degrees, doctors will suggest that the patient wear a brace for 18 hours a day. For curves greater than 45 to 50 degrees, surgery may be needed.

The most common surgical treatment for scoliosis is spinal fusion, using special titanium screws, hooks, rods and bone graft to carefully straighten the curve through incision along the back of the spine.

Curves that are more than 80 to 90 degrees may affect the child's heart and lungs, which can be life-threatening. Scoliosis in children is usually detected at school screenings.

NUH's Prof Liu said: "There is a need (for young people with scoliosis) to do six-to 12-monthly reviews until skeletal maturity to avoid undetected progression of scoliosis. Those who have been prescribed to wear braces should wear them."

Some practitioners offer alternative treatments.

Dr Will Kalla, a chiropractor from Precision Spine, said his treatment aims to "retrain and recalibrate the body's perception of correct upright posture".

The worst case he has seen is a woman who had a 103-degree curve since she was 13. Today, the 34-year-old has a curved spine of about 200 degrees, breathing issues and frequent chest infections. She does rehabilitation exercises, prescribed by Dr Kalla, at home.

Dr Kevin Lau from Scoliosis & Spine Correction Clinic said the clinic is seeing more patients who want to be treated at an early stage of the condition, to avoid the need for surgery.

He said: "Our treatment is a holistic approach involving scoliosis exercises and we also look into the nutrition and lifestyle aspects."

Janice Tai

A version of this article appeared in the print edition of The Sunday Times on November 11, 2018, with the headline 'SGH sees more cases of scoliosis with greater awareness'. Print Edition | Subscribe