The Argonaut Interview: Dr. Hooman Melamed

By Gary Walker

Not much is known about the physical ailment called scoliosis. It is defined as an abnormal curvature of the spine that occurs typically during a growth spurt during puberty.

Scoliosis may go undetected because mild spinal curves are not immediately visible and the condition rarely causes pain in children. In some cases, however, the condition can become painful, according to spinal surgeons, especially if the deformation of the spine reaches more than 50 degrees.

The spinal affliction at times requires surgery, but many patients can live with the affliction without major physical complications. Others with abnormally curved spines, however, can suffer from pain and discomfort and may consider surgery for relief.

Those with milder forms of the condition can function as well as those without scoliosis – some even at higher levels than most.

The multiple gold medal winning sprinter, Olympian Usain Bolt of Jamaica, has scoliosis. His right leg is reportedly shorter than his left leg.

Ladies Professional Golf Association champion Stacy Lewis has had scoliosis since she was 12. On June 12, she won her second LPGA tournament of the year, which proved to be impeccable timing because June was Scoliosis Awareness Month. She wore a back brace for seven and a half years and is now a spokeswoman for the Scoliosis Foundation.

According to most types of scoliosis are more common in girls than boys, and girls with scoliosis are more likely to need treatment. Doctors at the Mayo Clinic in Rochester, Minn. say scoliosis can run in families, but most children with scoliosis do not have a family history of the disease.

Genetic testing for scoliosis recently became available in 2009.

Dr. Hooman Melamed is a board certified orthopedic spine surgeon at Marina Del Rey Hospital who has performed numerous surgeries on patients who have scoliosis.

He specializes in minimally invasive spinal surgery, complex cervical spine disorders; cervical, thoracic and lumbar degenerative disc disease revision spine surgeries; second opinions; spine trauma/tumor and pediatric and adult scoliosis.

Melamed has been the lead author on multiple published peer-reviewed papers and has presented his research at several meetings including the Scoliosis Research Society, the Cervical Spine Research Society and the North American Spine Society.

The surgeon, who has volunteered in other countries to treat children afflicted with scoliosis, talked to The Argonaut about research on spinal deformation, the differences in how it manifests in children, adolescents and adults, and how the proper diagnosis and medical approach can alter the life of a patient with scoliosis.

Is it true that the cause of scoliosis is largely idiopathic, or unknown?

Yes. Sometimes a person can be afflicted by scoliosis from birth, but most of the time we don’t know how it happens.

How do patients typically learn that they might have this condition?

Parents of children often learn about it through routine physical examinations. In adults, there might be leg or back pain. X-rays would show scoliosis.

What are some of the symptoms?

A change in the spine where the head is off center or a shoulder that appears higher than the other.

In severe cases, chest pain and shortness of breath are common symptoms.

Is there current research being done on this spinal condition?

Yes, by the Scoliosis Research Society and other doctors. But there is nothing concrete yet.

For much of the public, the spinal condition came to the public consciousness after it was disclosed that the Jamaican Olympic gold medalist Usain Bolt has scoliosis. While not everyone will be able to perform at such a high level of competition, do you think his story can be inspirational to some who have mild scoliosis?

I didn’t know that Usain Bolt had scoliosis; it must be a mild case. I’m surprised to learn that he has scoliosis but I think it can be inspirational.

As with many medical conditions, children and teenagers with this affliction can still do many things that their peers can do, correct?

Yes. If the curvature of their spine is not very pronounced, they can be very highly functional.

While it appears to affect girls more than boys, is scoliosis more prevalent in certain ethnic groups?

It appears to affect all races and ethnic groups. For girls, depending on how young they are and how severe the condition, it can affect their self esteem.

The two primary treatments for scoliosis are bracing and surgery, correct?

Yes. With children and teenagers we often try bracing first because they usually don’t have much pain. With surgery, it often depends on what school of thought you come from.

Sometimes surgery might be the only option because depending on the degree of curvature, scoliosis can be quite debilitating. Others have injections into their spine and others use physical therapy. It really depends on the degree of curvature and if the patient is in significant pain.

Bracing typically is the only non-operative treatment for children and teenagers and it can have some success in preventing the progression of scoliosis.

What is considered an extreme curvature?

Forty-five to 50 degrees or higher. That is when surgery could be recommended.

Have you operated on patients with severe curvatures?

I operated on a patient with a curvature of 116 degrees.

What kind of success rate is there for patients who undergo surgery?

Kids tend to do pretty well after surgery. We have also seen adults who are in pain do well also.

For those who are in pain, with the right diagnosis, it can change their life.