Scoliosis is a term that defines abnormal curvature of the spine. The spine, from the rear view, is straight, but when looked up from the side has a very slight S-shape curvature. A person diagnosed with scoliosis may have a curve or S-shaped spine from the rear view. These curves may look like a severe S curves, called double curves, or a C-shape curve in the spine, severely throwing off upper body support and causing difficulty walking, limited range of motion, and for some individuals, difficulty breathing.
Scoliosis may cause conditions called hypokyphosis, a condition where inadequate backward curving of the upper spine causes pain, compressed nerves and limited mobility. Another condition, called hyperlordosis, is more commonly known as sway back. A condition where the curve of the upper back is especially pronounced produces a rounded back known medically as kyphosis or hyperkyphosis.
Treatment for scoliosis will depend on the age of the patient and the severity of the curvature. Nonsurgical treatment options are usually begun first, followed by surgery when necessary.
Benefits of Scoliosis Treatment
Anyone diagnosed with abnormal curvature of the spine may not only have to live with disfigurement, but back pain, difficulty moving, breathing, and limited enjoyment of daily activities. Individuals who are treated for scoliosis at a young age receive beneficial treatments and prognosis. In many cases, scoliosis conditions can be drastically reduced in young childhood and young adulthood, but the longer you wait, the less nonsurgical treatment options prove effective.
Nonsurgical Scoliosis Treatment
Nonsurgical scoliosis treatment consists of bracing and exercise. The severity or degree of the curvature as well as its location may benefit from spinal support braces and exercise routines that help gradually straighten the spine. Individuals with curvature of less than 20° usually don't receive any kind of treatment, though the condition may be carefully watched as the child grows. If the curvature is 30° or more and the child is still experiencing growth spurts, medical professionals typically recommend a back brace to help straighten the spine.
Back braces for scoliosis are custom-made for the individual and take into consideration size, degree of curvature, and prognosis. The brace is usually worn until the individual completes the growing process at the end of adolescence.
Individuals wearing braces are encouraged to undergo an exercise program that involves stretching, muscle strengthening and flexibility, all of which help create a stronger core and back.
Surgical Scoliosis Treatment
Several surgical methods are recommended for scoliosis treatment, though surgical procedures are generally not recommended for those with more than a 45 to 50° curvature. Scoliosis surgery focuses on fusing the vertebrae along the curve part of the spine and grafting bone chips to help encourage growth of the spine in a straighter pattern. Bone grafts are generally taken from the hipbone.
In addition to the bone grafting procedures, metal rods, screws, wires and hooks may be implanted until the spine fuses and grows strong enough to support itself. In most cases, such devices are left in the back without causing any health problems or issues, but will again depend on the type of surgery and the successful fusion of vertebrae. Fusion procedures usually heal within 3 to 12 months, depending on severity of the curvature, surgical approach, and the overall condition of the vertebrae.
Several common types of fusion surgical procedures are available to patients diagnosed with scoliosis.
•Anterior and posterior fusion
Anterior fusion means that the surgeon will access the vertebrae of the spine from the front of the body. This approach is recommended for individuals diagnosed with kyphosis, or congenital scoliosis. An incision is made in the front of the abdomen and internal organs retracted for easier viewing of the spinal column. The procedure is performed through an instrument called a thoracoscope, an endoscope designed for use in the abdominal cavity between the ribs. The instrument is similar to a laparoscopic surgical tool that requires smaller incisions. The thoracoscope is fitted with a telescope and camera like a laparoscope.
Posterior fusion is performed through a long incision along the spine. Screws, hooks, rods and wires are placed in position through this incision. The anterior and posterior fusion procedure consists of both a front and back or anterior and posterior surgical approach. Anterior fusion will be performed first, and then posterior fusion for additional support for the spine may be done at the same time, but more often than not is done in a separate operation.
Cost of Spinal Fusion Surgery
With the cost of hospital stay, medications, surgery fees and anesthesia the spinal fusion procedure is pricey. In the United States, prices range anywhere from $50,000 to $100,000, while in India costs range from $8,400 - $10,250. In Malaysia, costs are anywhere from $6,700 to $8,250. In many cases, some portions of the cost of spinal fusion treatments may be covered by medical insurance, though it's wise to ask your healthcare provider exactly which services will be covered.
Choosing a Surgeon for the Procedure
When deciding on an orthopedic surgeon for the spinal fusion procedure, it is important to find an experienced and qualified professional who has experience with different techniques for spinal fusion procedures. Be sure to check the facilities before settling on a surgeon, and make sure that they are accredited, and that surgeons and their staff are trained, experienced and certified in their field.
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