This document discusses scoliosis treatment options. Scoliosis is an abnormal curvature of the spine that can be caused by congenital defects, neuromuscular conditions, degeneration, or idiopathically. Treatment depends on the type and severity of scoliosis, with observation for mild cases, bracing to prevent worsening of moderate cases, and surgery to correct severe or worsening curvatures. Surgical treatment aims to halt progression, straighten the spine, and fuse vertebrae through bone grafting.
2. Scoliosis
• Scoliosis is an abnormal curve in the spine.
• Types of scoliosis based on the cause and age
• Scoliosis curves are often described based on the direction and
location of the curve
• The most common symptom of scoliosis is curvature of the
spine.
3. Types of Scoliosis
• Congenital scoliosis: Caused by a bone abnormality present at birth.
• Neuromuscular scoliosis: A result of abnormal muscles or nerves.
Frequently seen in people with spina bifida or cerebral palsy or in those
with various conditions that are accompanied by, or result of paralysis.
• Degenerative scoliosis: This may result from trauma (from an injury or
illness) bone collapse, previous major back surgery, or osteoporosis
(thinning of the bones).
• Idiopathic scoliosis: The most common type of scoliosis, idiopathic
scoliosis, has no specific identifiable cause. There are many theories, but
none have been found to be conclusive. There is, however, strong evidence
that idiopathic scoliosis is inherited.
5. Spinal Curvature
Direction Location
Dextroscoliosis Levoscoliosis
• Spinal curve to the right
• Occurs in the thoracic spine
• Occur on its own forming a "C"
shape
• Curve bending the opposite way
in the lower spine forming an "S"
• Spinal curve to the left
• Occur in the lumbar
spine
8. How to find Scoliosis
• Tilted, uneven shoulders, with one shoulder blade protruding
more than the other
• Prominence of the ribs on one side
• Uneven waistline
• One hip higher than the other
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9. Treatment Depends on…
• Gender - females are more likely to have progressive scoliosis
(gradually getting worse) than males
• Severity of curve - the larger the curve the greater the risk is
of it worsening over time
• Location of the curve - if a curve is located in the thoracic
(center) part of the spine it is more likely to get worse over
time compared to curves in the lower or upper section.
10. • Bone maturity - the risk of
curve progression is much lower
if the patient's bones have
stopped growing. Braces are
much more effective while
bones are growing.
• Casting - in early cases the
child's spine may have to be
guided back into its normal
position as it grows.
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11. Treat or Not to Treat?
Observation Bracing
Surgical
Intervention
12. Observation
• The doctor will check every
4 to 6 months - if curve is
getting better or worse.
• Used for those who have a
curve of less than 25
degrees and are still
growing.
13. Bracing
Doctors may advise wearing a brace to stop a curve from getting
worse, may be used when:
• The person is still growing and has a curve of more than 25-30
degrees.
• The person is still growing and has a curve between 20 -29
degrees that is getting worse.
• Person has at least 2 years of growth remaining and has a
curve that is between 20 -29 degrees. If a girl, she should not
have started having her monthly periods yet.
14. Surgery
Surgery Criteria
– Curve more then 40 degree
– Progressive increase in
scoliosis
– Failure to conservative
treatment
– Cardiopulmonary
complications
Surgical Approach
– Posterior Surgical Approach
– Anterior Surgical Approach
15. Objective of Surgery
• To halt progression of the deformity
• To straightened the curve (including Objectives rotational
component)
• To arthrodesis the entire primary curve by bone grafting
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