Scoliosis surgery and observation – 2022


Scoliosis surgery and observation

The treatment of very mild scoliosis is based on observation. Surgery is used for very severe scoliosis.

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Scoliosis develops in a vicious circle

Scoliosis is a deformation of the spine that can occur in apparently healthy children and teens. In a growing skeleton, it triggers a worsening process in a vicious circle, as already described. The result is the asymmetrical growth of the vertebrae and the alteration of posture. Recognizing the situation as soon as possible is essential to prevent scoliosis curves from worsening and to limit damage to the young person’s future life. The interventions are simple observation, gymnastics, bust and surgery. The most suitable scoliosis treatment is chosen on the basis of the age and growth phase of the child and the severity of the condition upon its discovery.


The treatment of very mild scoliosis is based on observation. In fact, when the asymmetries of the back are not very accentuated and the rotation of the vertebrae is under a specific threshold, it is preferable to monitor the situation. Checks are carried out by doctors or physiotherapists every 4-6-12 months depending on the severity. Each time the back is measured to assess whether the small abnormalities found at the first visit remain stable, improve or worsen. In case of worsening, back x-rays allow you to investigate the spine from the inside and measure its curves. With the x-ray, the doctor understands if you are facing real scoliosis, how severe and in which phase of bone growth the child is (initial phase-peak growth-advanced growth phase). Based on this information, he will propose the most appropriate treatment to control that scoliosis, in that phase of growth.


When the situation worsens, specific exercises for scoliosis can be intervened, taught by trained and specially trained professionals. It is therefore a gymnastics aimed at rebalancing the strength and length of the muscles of the body. In particular, it works on the deep muscles, which are inserted into the spine and which, like a scaffold, make it stable and strong. Of course, these exercises do not allow to correct the scoliosis curves by “straightening” the spine, which is not possible. However, they manage to rebalance the weight on the vertebrae and decrease the abnormal compression on the bearings between one vertebra and the other. By doing this, the vicious circle described above is slowed down and worsening of mild scoliosis is prevented.


Treatment of scoliosis may require bracing, when x-rays show significant scoliosis and when the boy is still growing. Prescribed by the medical specialist, it is a kind of body lining, made of rigid plastic and metal. This sort of outer shell applies pressure to the spine to reduce deformities. Worn many hours a day, it can prevent abnormal wedge-shaped growth of the vertebrae if gymnastics no longer give sufficient results. The bust is a scientifically effective treatment for medium severity scoliosis. Of course, it doesn’t make the spine go back straight. Unfortunately, in fact, the scoliosis curves cannot be reset. On the other hand, it is possible and necessary to prevent them from worsening to extreme degrees, incompatible with a good quality of life in adulthood.


Surgery is used for very severe scoliosis. It happens when the deformation of the spine and rib cage risk becoming so heavy in adulthood that they compress vital organs, such as the heart and lungs. The most important scoliosis, in fact, continue to worsen, albeit slowly, even once the boy’s growth has ended and the skeleton of the spine is now ossified. It is estimated that 3 in 1,000 people undergo surgery for scoliosis. During the operation, screws and bars are inserted to produce a sort of welding of the spinal column. The goal is to stop it from worsening. However, this also results in the reduction of a large part of the mobility of the back. Although surgical techniques have improved over time, risks such as infections, bone healing problems and, albeit rarely, paralysis still occur today.


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