Scoliosis Treatment in India

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Scoliosis Treatment

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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.

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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.

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Types of Scoliosis
Congenital scoliosis
Neuromuscular scoliosis
Degenerative scoliosis
Idiopathic scoliosis
Infantile idiopathic scoliosis
Juvenile idiopathic scoliosis
Adolescent idiopathic scoliosis

• less than 3 years old

• between 3-10 years of age

• over 10 years old

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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

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Spinal Curvature
Direction
Location
Thoracolumbar scoliosis
Thoracic scoliosis
Lumbar scoliosis

• curvature that includes vertebrae in both the
  lower thoracic portion and the upper lumbar
  portion of the spine

• Curvature in the middle (thoracic) part of the
  spine

• Curvature in the lower (lumbar) portion of the
  spine

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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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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.

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• 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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Treat or Not to Treat?
Bracing
Observation
Surgical Intervention
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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.

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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.

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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

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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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