Scoliosis Therapy

Scoliosis Therapy: Exploring Treatment Options

Does everyone require scoliosis therapy?

In most cases, around 90% of scoliosis patients have a low degree curvature that does not necessitate immediate therapy. However, periodic X-rays during adolescence are essential to monitor for any increase in the scoliosis curvature. If there is progression, therapy needs to be planned accordingly.

What factors are crucial in scoliosis therapy?

Several factors play a significant role in determining the appropriate scoliosis therapy:

  • The patient's age
  • The patient's bone age (not always the same as biological age)
  • The patient's gender
  • The patient's stage of adolescence
  • The size and location of the scoliosis curvature
  • The rate of curvature increase
  • The presence of back pain or respiratory issues

What are the available options for scoliosis therapy?

There are three main options for scoliosis therapy: monitoring, bracing, and surgery.

Monitoring:

  • Suitable for low-sized curvatures in adolescent patients (adolescent scoliosis).
  • Also used for mid-sized (below 45 degrees) curvatures in adult patients.
  • Follow-up visits are recommended once every 6 months until the age of 20, and annually thereafter.

Bracing:

  • Applied for curvatures between 25-45 degrees.
  • Designed to halt the progression of scoliosis in the growing spine of a child.

Surgery:

  • Reserved for curvatures larger than 50 degrees.
  • May be considered for lower degree scoliosis if it causes discomfort or other clinical complaints.
  • The main goal is to correct the scoliosis curvature by fusing the corrected vertebrae together using metal implants.

How is scoliosis therapy determined for adolescents?

In planning therapy for children, the severity and location of the scoliosis curvature are crucial factors. The child's age and the potential for spinal growth also play a role in deciding the most appropriate treatment. An experienced physician can predict the course of scoliosis and recommend suitable therapies tailored to the patient's needs.

Which factors contribute to the success of bracing in scoliosis?

The success of bracing is influenced by:

  • Early diagnosis of scoliosis during childhood
  • Smaller size (lower degree) of the curvature
  • Regular orthopedic monitoring
  • Proper fit and compliance with the brace
  • Support from family
  • Engaging in scoliosis exercises, stretching, swimming, dancing, or yoga

What type of brace is used in scoliosis treatment?

The choice of scoliosis brace depends on several factors, including the location, flexibility, and number of curvatures, as well as the patient's overall health. Braces can be either hard (plastic) or soft (elastic), and each brace is customized for the individual patient to provide the best corrective pressure on the scoliosis.

Does brace treatment effectively work?

Studies have shown that brace treatment is successful in preventing scoliosis curvature from progressing to a level that would require surgery. The curvature generally decreases while wearing the brace and may remain reduced or stable after the spinal growth is completed. However, some patients may experience scoliosis progression despite brace treatment.

How long should brace treatment continue?

Brace treatment should continue until the patient's spinal growth is completed. The duration may vary depending on the individual patient, and regular monitoring by the doctor is essential, usually once every 4-6 months.

Are there nighttime-use braces available?

Many factors influence the type of brace a patient should use. While most braces are worn for 16-23 hours a day, some are only used during nighttime sleep.

What happens if braces are not used?

Failure to use a recommended brace may result in the progression of scoliosis, potentially leading to the need for surgical intervention.

What factors influence the decision for scoliosis surgery?

Several factors play a role in deciding whether surgery is necessary, including the location and size of the scoliosis curvature, the presence of accompanying kyphosis, pain, remaining potential for growth, and other individual patient factors.

Before undergoing surgery, what questions should be asked?

Patients considering surgery should discuss various aspects with their doctor, including:

  • Risks associated with the surgery
  • Preoperative tests
  • The surgeon's experience and success rate
  • The duration of surgery
  • Postoperative pain management
  • Blood donation during surgery
  • Hospital stay length
  • Physical restrictions post-surgery
  • Brace treatment after surgery
  • Physical therapy after surgery
  • Showering guidelines after surgery
  • Resuming school, work, and sports activities
  • Potential limited range of motion
  • Fusion bone location (using the patient's own body or an external source)
  • Dental care considerations after spinal fusion
  • Security detector alarms due to metal implants
  • Possibility of additional operations
  • Availability of psychological support for preparation

Does smoking impact spinal fusion?

Yes, smoking can delay tissue healing, potentially leading to fusion failure. Therefore, it is essential to quit smoking before undergoing scoliosis surgery.

Is it possible for the metal implants to rust or be rejected by the body?

Metal implants used in scoliosis surgery cannot rust or be rejected by the body.

What happens if a patient receives no treatment?

Patients diagnosed with scoliosis before the age of 10 and with a Cobb angle of more than 35 degrees may experience progression if left untreated. In adult patients, scoliosis may progress at a rate of 1-1.5 degrees per year for angles greater than 50, but typically not for angles less than 30.

BEFORE & AFTER

View transformations in our patients' before and after photos.

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