Known internationally for his minimally-invasive approach to scoliosis treatment, George D. Picetti, III, M.D., has developed new treatment options for adults and children with scoliosis and degenerative lumbar disorders. His innovative approach to spine and scoliosis surgery minimizes incision scarring and reduces the amount of damage to tissue and blood loss occurring during surgery...more

For more information or an appointment with Dr. Picetti, please call 916-454-6850.

Sutter Neuroscience Institute is proud to be able to offer children and adults one of the nation's leading scoliosis diagnostic and treatment centers, including minimally invasive scoliosis correction. Patients travel from many parts of the country and other parts of the world to receive scoliosis care through Sutter spine surgeons.

Scoliosis refers to curving of the spine from side to side. The spine viewed from the front or back should show a straight line from tail bone to head. Scoliosis is the name applied when the spine shows a left or right curve in a "C" or "S" shape. Because the spine is three dimensional, scoliosis curves often include twisting as well.

This common condition affects about 2 percent of the population, appearing more often in females than males. Scoliosis can be present at birth or develop at any age, though it most typically appears during adolescence. It can also be part of a neuromuscular condition, such as cerebral palsy and spine bifida. Treatment for scoliosis as part of a more encompassing disorder often provides patients welcome relief and improved comfort, especially for those who are wheelchair bound.

Where scoliosis is not caused by a neuromuscular disorder, there are three distinct types:

• Congenital scoliosis is present at birth and is thought to be caused during the first 5-6 weeks of pregnancy, even before the mother is aware she is pregnant. Partially formed vertebrae may cause little or no effect on a child's development or may be part of a group of defects, which may include the spinal cord, kidneys and heart. Treatment depends on the nature of the defect and can include surgery, either in infancy or as the child grows.
• Idiopathic scoliosis typically appears in adolescence (ages 10 to 18), though it can appear in children of all ages, as well as adults. About 80 percent of all scoliosis cases fall under this category. Idiopathic means "arising from no known cause," though this form of scoliosis does tend to run in families, giving rise to the assumption of a genetic link. If a family member has scoliosis, the possibility that other family members will develop it increases to 20 percent, compared to a 2 percent incidence in the general population. Typically, as a child reaches puberty, the spine that appeared normal in childhood begins to curve and possibly twist.

Depending on the amount of twisting and curvature, correction may require only monitoring, physical therapy, bracing, or some combination. In more severe cases, surgery to correct the curvature appears to offer the most lasting correction as the adult spine takes shape. Surgeries also vary and often include implanting metal rods, screws and other devices that act as internal braces to guide the spine's growth.

• Adult scoliosis typically results from earlier untreated or incompletely treated scoliosis, but can also develop as an effect of spinal stenosis, osteoarthritis and other degenerative spine conditions. Even when adult scoliosis comes about from adolescent idiopathic scoliosis, premature aging causes degenerative issues, such as bone spurs, degenerative discs and other issues that can increase pain enough to require treatment. As with all scoliosis, treatment varies depending on the degree of curvature, as well as the patient's age and health.

Patients and family members are often the first to detect scoliosis, though school screenings also help spot adolescent idiopathic scoliosis. When patients come in for an examination, they will undergo spinal X-rays to give doctors a clear picture of the curvature. The doctor may also request a computed tomography (CT) scan of the spine or magnetic resonance imaging (MRI) of the spine to spot degenerative complications and get a more detailed look that includes the effect spinal curvature is having on the spinal cord and nerves, and on surrounding tissues and organs.

Treatment can include watchful waiting, physical therapy, spinal bracing, minimally invasive or traditional surgical care. The doctor determines the best course of care by considering the patient's age and health, as well as the severity of the curvature and its impact on mobility, and neurological and organ function. Children through adolescence receive care through a combined program of Sutter Neuroscience Institute and Sutter Children's Services to ensure they feel comfortable and secure during all testing and treatment.

More information is available under scoliosis in our Healthwise health information. The Other Places To Get Help section of the Healthwise article offers additional resources for information and support. In addition, the National Institutes of Health MedlinePlus® provides encyclopedia information in the scoliosis section, and additional information and resources under the scoliosis health information topic

Scoliosis: Minimally Invasive Surgery

Sutter spine surgeon George Picetti, M.D . was one of the pioneers who helped develop minimally invasive scoliosis surgery. Instead of the traditional large incisions, minimally invasive surgery uses small scopes with cameras that allow surgeons to perform surgery through half-inch incisions. In follow-up studies, the minimally invasive approach has proven effective, with shortened recovery times and fewer complications. This approach is not possible with all cases, so each patient must undergo a careful evaluation to determine if minimally invasive surgery is indicated. Click here to view Dr. Picetti's write-up on the procedure.

For more information about scoliosis or an appointment with Dr. Picetti, please call 916-454-6850.

For more information on bone and joint conditions, select one of the following:

For more information on deformity conditions, select one of the following:

• Scoliosis
• Kyphosis
• Kyphoscoliosis
• Spina Bifida