How is scoliosis treated?
The treatment options for scoliosis are often complex and each case requires a thorough analysis by a doctor or specialist. There are a number of options for treatment which include braces and several surgical procedures.
The majority of children who have scoliosis tend to have curves that are mild and will not require treatment through bracing or surgery. In these instances, routine check-ups every six months or so are necessary for a doctor to monitor curvature of the spine and whether this progresses or not. The primary treatment for mild scoliosis is observation.
In terms of moderate (25 to 70 degrees) to severe curves (more than 70 degrees)2, treatment commencement and options will depend on the affected individual. There are several factors that a doctor will consider in order to decide whether to treat the condition or wait and monitor it for signs of progression. These include:
- Gender – Females have a higher risk of scoliosis progressing in comparison to their male counterparts.
- Curve severity – The larger the spinal curves, the higher the odds of progression (which will take place over a number of years).
- Curvature pattern – If a double curve, also referred to as an S-shaped curve is present, this will often progress more rapidly and severely than a C-shaped (single) curve.
- Curvature location – A curve located in the thoracic centre of the spine is known to progress and worsen more than curves in the lower and uppers sections of the spine.
- Maturity – As an adult, skeletal maturity is reached and growth stops, lowering the chances of curvature progression. Children who still have some growing left to do have a higher risk of curve progression. As a result, braces tend to be the most effective means of treatment in children who are not yet fully grown.
- Other health conditions – If an affected person has a health concern such as a lung or heart condition and their scoliosis is severe, then immediate treatment may be required so as to limit any complications associated with the rib cage pressing on the heart and lungs.
Predicting the rate of curvature progression
In adolescents and children – Once an abnormal yet mild curvature of the spine has been detected, a doctor will predict whether the condition is likely to progress and become more serious and treat it accordingly.
Progression is purely based on the individual, making it a highly variable aspect and difficult to predict with precision. Three in every 100 adolescents have scoliosis that is severe enough to require at least observation by a doctor2.
Doctors are unable to rely on a definitive risk factor to determine the rate of progression. There is some evidence that suggests that the below-mentioned risk factors can help in determining one’s risk factors:
- Greater curvature angle – An example of how prediction works on the angle of spinal curvature is if the curve is only 20 degrees, then it may only progress by roughly 20 percent. Younger people who are diagnosed with scoliosis and have a 30-degree curve have a higher risk factor as the curve may progress more than 60 percent. If the curve is 50-degrees or more, it may progress more than 90%.
- Spinal issues present at birth – If spinal curvature is the result of congenital scoliosis, then it has a high chance of rapidly progressing.
Curvatures tend to progress at a slower rate in girls who have scoliosis of the lower back and if the spine is out of balance by more than 2.5 centimetres (1 inch)2.
Height also has a role to play. If a girl is shorter than the average height of other girls her age and scoliosis is present in the lower back with an angle of 25 to 35 degrees, she may have little to no risk of progression.
In adults – Some cases of scoliosis that remained undetected or went untreated in youth may develop further and progress into adulthood. The following describes the factors of spinal curvatures in adults and their potential risk of progression:
- Curvatures that are less than 30-degrees are not likely to progress.
- Ways to accurately predict curvature progression of curves that are roughly 40-degrees has not yet been identified.
- Curvatures that are more than 50-degrees have a higher risk of progressing.
Treatment options for scoliosis:
Braces (non-invasive treatment)
Braces are commonly prescribed for children in order to prevent any further curvature progression in curves that are 25 to 40 degrees. Curvature progression in children will be well-documented for reference and monitoring purposes as they grow.
Doctors do not usually prescribe braces for adults with scoliosis due to the fact that this form of treatment is unable to improve the disorder once skeletal maturity is reached. In certain cases, if an adult patient suffers from severe pain, some doctors may recommend a brace as they believe it may able to reduce spinal motion and provide the necessary support to help alleviate pain.
Wearing a brace will not cure scoliosis, nor will it reverse the curvature but it may be able to reduce the rate at which the curve progresses.
The most commonly used braces are made of plastic and contoured to fit the body and conform to it. A brace that is close-fitting around the rib cage, hips, lower back and under the arms can be nearly invisible when worn under clothing.
Options for braces
Generally, there are two different options for scoliosis braces, these include:
- Braces that are worn full-time – Full-time braces are made to be worn for between 16 and 23 hours of the day. The goal is to wear them at all times, except when exercising or bathing.
- Braces worn during the night – Night-time braces make use of hyper-corrective forces, these work by putting the body out of its “normal” balance and cannot be applied when a child is standing or performing daily activities. These braces are worn during the night for roughly eight hours.
Braces will be discontinued once a child’s bones stop growing, this will typically occur:
- Roughly two years after a girl starts menstruating
- When a boy starts shaving daily
- When there are no additional changes to height
When choosing between full-time braces and braces worn during the night, a doctor will look at the location of the spinal curves and what a child prefers. In some cases, night-time braces may be more effective due to the majority of patients being more likely to wear them as this is often more practical and easier to adhere to and helps the sufferer to avoid any associated self-consciousness. Some experts have noted that full-time bracing is more effective, however, this form of bracing is not always as easily accepted among patients.
Currently, experts and medical professionals have not reached a consensus on whether full-time or night-time bracing is best. If the spinal curve is 35-degrees or less, then a doctor may recommend that a child use either a night-time or full-time brace as he or she sees fit. If the curve is 35-degrees or more then a child may be urged to wear a full-time brace.
Other nonsurgical options (these are largely unproven)
The other scoliosis treatments that do not involve surgery may include5:
- Electrical stimulation
- Nutritional supplements
- Chiropractic treatment
Some people claim that treatments like manual manipulation and physical therapy are able to prevent scoliosis from progressing, however, the scientific evidence to back these beliefs is lacking, therefore, these claims cannot be supported. Currently, bracing is the only form of nonsurgical treatment that has proven to reduce spinal curves associated with idiopathic scoliosis from naturally progressing.
This is not to say that these techniques are not helpful to sufferers, however, they cannot stop scoliosis progression.
Some doctors believe that exercise is beneficial to those suffering from scoliosis as it may aid in keeping the back flexible and strong.
When braces fail
In some cases of idiopathic scoliosis, spinal curvature may continue to progress regardless of bracing. Should curvature progress beyond 40 to 50 degrees, surgery might be recommended by a doctor.
A number of adults with scoliosis will not have specific symptoms and will not require any surgical treatment. Because of this, the below section is aimed at children with scoliosis.
The goals of surgery for scoliosis
The surgery for scoliosis will typically have the below-mentioned goals:
- To prevent the curve from progressing – If a child’s doctor recommends surgery, it will be due to the severity of the spinal curve and any associated deformation progressing. Surgery for scoliosis will therefore attempt to prevent worsening of the curve.
- To reduce deformity of the spine – A doctor will evaluate a child’s spinal flexibility as the surgery for scoliosis can untwist any abnormal rotation of the spine and also correct any lateral curvature by roughly 50 to 70 percent. These changes may enable a child to stand up straighter and reduce the rib hump on their back.
- To maintain the trunk balance – If any changes need to be made to the positioning of the spine, then the surgeon will consider a child’s overall trunk (torso) balance and attempt to maintain some of the spine’s natural lordosis and kyphosis curvature. At the same time, he/she will also attempt to keep the legs and hips as even as possible.
Before making adjustments to the spine, the surgeon will consider the effects these will have on a child’s spinal cord. The health of the spinal cord will need to be monitored throughout the scoliosis surgery. The spinal cord is the road for connecting information from the brain and the nervous system, and any injury or trauma to this can result in severe complications that will have an impact on daily life and physical activities.
Surgical options for idiopathic scoliosis
Generally, there are three categories when it comes to surgery for scoliosis, these include:
- Fusion – This form of spinal surgery involves permanently fusing two or more vertebrae that are adjacent to each other so as to allow for them to grow together at a spinal joint and therefore, create a solid immobile
There are a number of modern approaches to this surgery which involve instrumentation such as screws, hooks, rods or wires that are placed within the spine to allow for a more efficient curvature correction to be achieved as well as a faster recovery time.
The different methods of spinal fusion include:
- Taking bone from the pelvis or from a bone bank and using this to create a bridge between adjacent vertebrae. This bone graft will assist new bone to grow.
- Using a metal implant to hold adjacent vertebrae together, this will then be removed when new bone has grown between them.
Spinal fusion is a major surgery and tends to last several hours. One of the main advantages of having spinal surgery is that it has a long-term record of efficacy and safety in the treatment of scoliosis. The drawback of spinal surgery is that a child is exposed to post-surgical risks such as infection and may lose mobility and have their twisting and bending capabilities limited. However, with today’s medical advances, surgeons are able to fuse fewer vertebrae together and thus greater mobility can be retained in comparison to surgeries conducted in the past.
- Growing systems – This form of surgery is intended to delay spinal fusion. Growing systems are used in children who have rapidly progressive scoliosis at an early age. A growing rod with an adjustable length is implanted in an initial surgery and then lengthened by means of additional procedures every six to 12 months as a child continues to grow. When the child is closer to skeletal maturity, a doctor may then suggest that he or she has a spinal fusion conducted (if necessary).
When a spinal fusion is done at a very young age (this is typically when a girl is younger than ten years old and a boy is younger than 12), this may result in less room being left for the lungs to fully develop and leave the child with a shorter trunk in comparison to their limbs. In order for these complications to be avoided, a growing system will aid in guiding spinal growth and prevent a curve from progressing as the spine reaches maturity and eventually becomes ready for a spinal fusion (if need be).
- Fusionless (Vertebral Body Tethering (VBT)) – There are currently methods that involve applying constant pressure to a bone, which, in theory, will allow for it to grow denser and more slowly. When an outward curvature of the spine is present, a surgeon will attempt to slow down or block the curve’s growth by applying pressure to the outer side, while the inner side of the curve will continue to grow as usual. This allows for the spine to straighten over time. VBT specifically involves growth modulation and aims to preserve flexibility and growth through placing screws on the curve’s outer side and then tightening them through the use of a cord so as to straighten the spine.
Bear in mind, this approach is still a new one and requires additional research and findings in order for the benefits and safety aspects to be explored in more detail.
In the case of adolescents or young adults, spinal fusion remains the preferred scoliosis surgery recommendation.
Choosing surgery or braces
The below-mentioned criteria are generally used in determining whether a person affected by scoliosis should receive a brace, surgery or conservative treatments2:
- Braces are often used for children whose curvatures are between 25 and 40 degrees and where the child still has some significant growing to do.
- Surgery will be suggested if a child’s curvature is more than 50 degrees and he/she has not been previously treated for the condition or if a brace was ineffective. In adults, scoliosis does not generally progress to more than 40 degrees, however, surgery is sometimes an option if a severe amount of pain is present or if scoliosis results in neurological issues.
Bear in mind, that the choice between these options is not always straightforward and some specific cases will need to be further investigated in order to identify the most effective treatment options.
What types of specialists treat scoliosis?
A general practitioner or paediatric physician will typically notice any spinal issues initially, after which, he or she will consult with an orthopaedic surgeon or a neurosurgeon who specialises in spinal surgery. In addition to these specialists, a rehabilitation expert or a physical therapist may also be consulted.
Some people may require an occupational therapist or a neurologist to be a part of their treatment team on an ongoing basis. An occupational therapist aids in helping one to adapt to any physical incapability’s that may develop as a result of the condition or when recovering from surgery.
2. University of Maryland Medical Centre. 2012. Scoliosis. Available:http://www.umm.edu/health/medical/reports/articles/scoliosis [Accessed 07.09.2017]
5. Niams. 2002. Scoliosis in children and adolescents. Available: https://www.niams.nih.gov/health-topics/scoliosis [Accessed 06.09.2017]
Ugonjwa wa scoliosis hupatiwaje matibabu? Mara nyingi njia za kutibu ugonjwa wa uti wa mgongo ni tata na kila kisa huhitaji kuchunguzwa kwa uangalifu na daktari au mtaalamu. Kuna chaguzi kadhaa za matibabu ambazo zinatia ndani braces na taratibu kadhaa za upasuaji. Watoto wengi wenye ugonjwa wa scoliosis huwa na curves ambazo ni laini na hazihitaji matibabu kupitia bracing au upasuaji. Katika hali kama hizo, ni muhimu daktari afanye uchunguzi wa kawaida kila baada ya miezi sita ili kujua ikiwa ugonjwa huo unaendelea au la. Matibabu ya msingi ya ugonjwa wa uti wa mgongo wa hali ya chini ni uchunguzi. Kwa upande wa kupungua kwa uzito (kuanzia 25 ° hadi 70 °) hadi kupungua kwa uzito (zaidi ya 70 °), mwanzo wa matibabu na chaguzi zitategemea mtu aliyeathiriwa. Kuna mambo kadhaa ambayo daktari atazingatia ili kuamua kama atapima ugonjwa huo au ataangalia dalili za ugonjwa huo. Hizi ni pamoja na: - Jinsia <unk> Wanawake wana hatari kubwa ya scoliosis kuendelea ikilinganishwa na wenzao wa kiume. - Uharibifu wa curve <unk> Kadiri curves ya uti wa mgongo ni kubwa, ndivyo uwezekano wa maendeleo (ambayo itafanyika kwa miaka kadhaa) ni mkubwa. - Mfano wa curvature <unk> Kama curve mara mbili, pia inajulikana kama curve S-umbo, hii mara nyingi maendeleo kwa kasi zaidi na kwa ukali kuliko C-umbo (moja) curve. - curvature eneo <unk> curve ziko katika thoracic kituo cha uti wa mgongo ni inayojulikana kwa maendeleo na kuzorota zaidi kuliko curves katika sehemu ya chini na juu ya uti wa mgongo. - Ukomavu <unk> Kama mtu mzima, skeletal ukomavu ni kufikiwa na ukuaji huacha, kupunguza nafasi ya maendeleo curvature. Watoto ambao bado wanaendelea kukua wana hatari kubwa zaidi ya kuendeleza ugonjwa huo. Kwa hiyo, vifungo vya meno ni njia bora zaidi ya kutibu watoto ambao hawajakua kabisa. - Hali nyingine za afya <unk> Ikiwa mtu aliyeathiriwa ana wasiwasi wa afya kama vile ugonjwa wa mapafu au moyo na scoliosis yao ni kali, basi matibabu ya haraka yanaweza kuhitajika ili kupunguza matatizo yoyote yanayohusiana na ngome ya ribs inayofinyilia moyo na mapafu. Kutabiri kiwango cha maendeleo ya curvature Katika vijana na watoto <unk> Mara curvature isiyo ya kawaida lakini laini ya uti wa mgongo imegunduliwa, daktari atatabiri kama hali hiyo inaweza kuendelea na kuwa mbaya zaidi na kutibu ipasavyo. Maendeleo ni msingi tu juu ya mtu binafsi, na kufanya hivyo kipengele tofauti sana na vigumu kutabiri kwa usahihi. Katika kila vijana watatu, ugonjwa wa scoliosis ni mbaya sana hivi kwamba unahitaji daktari kumchunguza. Madaktari hawawezi kutegemea jambo la hatari la hakika ili kuamua kiwango cha maendeleo. Kuna baadhi ya ushahidi kwamba inaonyesha kwamba chini-alitaja sababu za hatari inaweza kusaidia katika kuamua moja ya sababu za hatari: kubwa curvature pembe, mfano wa jinsi utabiri kazi juu ya pembe ya curvature spinal ni kama curve ni tu 20 digrii, basi inaweza tu maendeleo kwa takriban asilimia 20. Watu vijana ambao wamegunduliwa kuwa na ugonjwa wa scoliosis na wana curve ya digrii 30 wana hatari kubwa zaidi kwani curve inaweza kuendelea zaidi ya asilimia 60. Ikiwa curve ni 50 au zaidi, inaweza kuendelea zaidi ya 90%. - Matatizo ya uti wa mgongo yanayopatikana wakati wa kuzaliwa <unk> Ikiwa umbo la uti wa mgongo ni matokeo ya ugonjwa wa scoliosis wa kuzaliwa, basi kuna uwezekano mkubwa wa kuendelea haraka. Mabadiliko ya mviringo huendelea kwa kasi ya chini kwa wasichana ambao wana scoliosis ya mgongo wa chini na ikiwa uti wa mgongo haupo sawa kwa zaidi ya sentimita 2.5 (1 inchi) 2. Urefu pia una fungu linalohusika. Ikiwa msichana ni mfupi kuliko urefu wa wastani wa wasichana wengine wa umri wake na scoliosis iko katika sehemu ya chini ya mgongo kwa pembe ya digrii 25-35 anaweza kuwa na hatari ndogo ya maendeleo. Katika watu wazima <unk> Baadhi ya visa vya ugonjwa wa uti wa mgongo ambavyo havikuonekana au havikutibiwa katika ujana vinaweza kuongezeka zaidi na kuendelea hadi ujana. Kwa mfano, kwa watu wazima, curvature ya uti wa mgongo inaweza kuwa na hatari ya kuenea, lakini kwa watu wazima, curvature ya chini ya digrii 30 inaweza kuwa na hatari ya kuenea. Njia za kutabiri kwa usahihi mwenendo wa curvature ya curves ambayo ni karibu digrii 40 bado haijagunduliwa. Kwa upande mwingine, curvature ya zaidi ya 50 ° ina hatari kubwa ya kuendeleza. Matibabu ya scoliosis: Vifaa vya matibabu ya watoto vinaweza kupewa kwa watoto kwa sababu ya kuepuka maendeleo ya curvature katika curves 25 hadi 40 °. Maendeleo ya curvature katika watoto itakuwa vizuri kumbukumbu kwa ajili ya kumbukumbu na madhumuni ya ufuatiliaji kama wao kukua. Kwa kawaida madaktari hawaagizi braces kwa watu wazima walio na scoliosis kwa sababu ya ukweli kwamba aina hii ya matibabu haiwezi kuboresha ugonjwa huo mara tu ukomavu wa mifupa umefikiwa. Katika kesi fulani, ikiwa mgonjwa mzima anaugua maumivu makali, madaktari fulani wanaweza kupendekeza brace kwa sababu wanaamini inaweza kupunguza mwendo wa uti wa mgongo na kutoa msaada unaohitajika kusaidia kupunguza maumivu. Kwa hivyo, kutumia brace haitaweza kuponya scoliosis, wala kugeuza mwinuko, lakini inaweza kupunguza kiwango cha maendeleo ya curve. Vifaa vinavyotumiwa kwa kawaida hutengenezwa kwa plastiki na kutengenezwa ili vifanane na mwili na kuendana nayo. Vifaa vya kuunganisha ambavyo vinafaa karibu na kifua, viuno, sehemu ya chini ya mgongo na chini ya mikono vinaweza kuonekana karibu wakati vinapovaliwa chini ya nguo. Kwa ujumla, kuna chaguzi mbili tofauti za braces za scoliosis, hizi ni pamoja na: - Braces ambazo huvaliwa wakati wote - Braces za wakati wote hutengenezwa kuvaliwa kati ya masaa 16 na 23 ya siku. Lengo ni kuvaa nguo hizo wakati wote, isipokuwa unapofanya mazoezi au unapoga. - Braces kuvaa wakati wa usiku <unk> Night-wakati braces kufanya matumizi ya hyper-korekodi nguvu, hizi kazi kwa kuweka mwili nje ya <unk>normal<unk> usawa wake na haiwezi kutumika wakati mtoto ni amesimama au kufanya shughuli za kila siku. Vifaa hivyo huvaliwa usiku kwa muda wa saa nane hivi. Wakati wa kupumzika, mifupa ya mtoto huanza kukua, na wakati wa kupumzika, mifupa ya mtoto huanza kukua, na wakati wa kupumzika, mifupa ya mtoto huanza kukua, na wakati wa kupumzika, mifupa ya mtoto huanza kukua. Katika baadhi ya kesi, braces usiku inaweza kuwa na ufanisi zaidi kutokana na wengi wa wagonjwa kuwa na uwezekano wa kuvaa yao kama hii ni mara nyingi vitendo zaidi na rahisi kufuata na husaidia mgonjwa kuepuka yoyote kuhusishwa na kujisikia. Wataalamu wengine wamebainisha kwamba utunzaji wa muda wote ni ufanisi zaidi, hata hivyo, aina hii ya utunzaji haikubaliwa mara zote kwa urahisi kati ya wagonjwa. Kwa sasa, wataalamu na wataalamu wa kitiba hawajafikia makubaliano juu ya kama ni afadhali kutumia vifungo vya mwili wakati wote au wakati wa usiku. Ikiwa mhimili wa uti wa mgongo ni digrii 35 au chini, daktari anaweza kupendekeza kwamba mtoto atumie brace ya usiku au ya wakati wote kama anavyoona inafaa. Ikiwa curve ni 35 ° au zaidi, mtoto anaweza kushinikizwa kuvaa brace ya wakati wote. Matibabu mengine ya scoliosis ambayo hayajumuishi upasuaji yanaweza kujumuisha: - Kuchochea umeme - Viongezeo vya lishe - Matibabu ya chiropractic - Watu wengine wanadai kwamba matibabu kama udhibiti wa mikono na matibabu ya mwili yanaweza kuzuia scoliosis kuendelea, hata hivyo, ushahidi wa kisayansi wa kuunga mkono imani hizi haupo, kwa hivyo madai haya hayawezi kuungwa mkono. Kwa sasa, braces ni aina pekee ya matibabu yasiyo ya upasuaji ambayo imethibitishwa kupunguza curves ya uti wa mgongo kuhusishwa na scoliosis idiopathic kutoka kwa maendeleo ya asili. Hilo halimaanishi kwamba mbinu hizo hazisaidii wagonjwa, hata hivyo, haziwezi kuzuia ugonjwa huo usisonge mbele. Wataalamu wa afya wanasema mazoezi ya mwili ni muhimu kwa wale wanaosumbuliwa na ugonjwa wa scoliosis, kwani yanaweza kusaidia kuweka mgongo wenye nguvu na wenye kubadilika. Wakati braces kushindwa Katika baadhi ya kesi ya scoliosis idiopathic, spinal curvature inaweza kuendelea maendeleo bila kujali bracing. Ikiwa curvature inaendelea zaidi ya digrii 40 hadi 50, upasuaji unaweza kupendekezwa na daktari. Watu wazima wengi walio na ugonjwa wa scoliosis hawatakuwa na dalili hususa na hawatahitaji upasuaji wowote. Kwa sababu hiyo, sehemu iliyo hapa chini imekusudiwa watoto walio na ugonjwa wa uti wa mgongo. Upasuaji wa scoliosis kwa kawaida una malengo yafuatayo: kuzuia curve kutoka kwa maendeleo: Ikiwa daktari wa mtoto anapendekeza upasuaji, itakuwa kwa sababu ya ukali wa curve ya uti wa mgongo na mabadiliko yoyote yanayohusiana. Kwa hiyo upasuaji wa ugonjwa wa uti wa mgongo utajaribu kuzuia mviringo usizidi kuwa mbaya. Kwa mfano, kwa mtoto aliye na ugonjwa wa scoliosis, daktari anaweza kuamua jinsi ya kuondoa mviringo wa mgongo na kuharibu mwinuko wa upande kwa asilimia 50 hadi 70. Mabadiliko hayo yanaweza kumsaidia mtoto kusimama wima zaidi na kupunguza mgongo wake. Ili kudumisha usawa wa shina la mgongo, daktari wa upasuaji atachunguza usawa wa jumla wa shina la mgongo na kujaribu kudumisha baadhi ya mwinuko wa asili wa lordosis na kyphosis ya mgongo. Wakati huo huo, yeye pia kujaribu kuweka miguu na viuno kama hata iwezekanavyo. Kabla ya kufanya marekebisho kwenye uti wa mgongo, daktari-mpasuaji atafikiria athari ambazo hizo zitakuwa nazo kwenye uti wa mgongo wa mtoto. Afya ya uti wa mgongo itahitaji kufuatiliwa wakati wote wa upasuaji wa scoliosis. Ugonjwa wa uti wa mgongo ni njia ya kuunganisha habari kutoka kwa ubongo na mfumo wa neva, na uharibifu wowote au majeraha kwa hii inaweza kusababisha matatizo makubwa ambayo yatakuwa na athari kwa maisha ya kila siku na shughuli za mwili. Upasuaji wa scoliosis ya idiopathic ni aina ya upasuaji ambao hujumuisha kuunganisha kwa kudumu viungo viwili au zaidi vya uti wa mgongo ili kuruhusu ukuaji wa pamoja katika uti wa mgongo na hivyo kuunda pamoja. Mbinu tofauti za kuunganisha uti wa mgongo ni pamoja na: - Kuchukua mfupa kutoka kwa pelvis au kutoka benki ya mifupa na kutumia hii kuunda daraja kati ya vertebrae jirani. Upasuaji huo wa mfupa utasaidia mfupa mpya kukua. - Kutumia implant ya chuma kushikilia vertebrae jirani pamoja, hii itakuwa kisha kuondolewa wakati mfupa mpya imekua kati yao. Upasuaji wa kuunganisha uti wa mgongo ni upasuaji mkubwa na huchukua saa kadhaa. Moja ya faida kuu ya upasuaji wa uti wa mgongo ni kwamba una rekodi ya muda mrefu ya ufanisi na usalama katika matibabu ya scoliosis. Upasuaji wa uti wa mgongo una athari kubwa kwa mtoto, kwa sababu ya hatari ya kuambukizwa na kupoteza uwezo wa kuendesha na kugeuka. Hata hivyo, kwa maendeleo ya kitiba ya leo, madaktari wa upasuaji wanaweza kuunganisha uti wa mgongo wachache pamoja na hivyo mwendo mkubwa unaweza kuhifadhiwa ikilinganishwa na upasuaji uliofanywa zamani. - Mifumo inayokua <unk> Aina hii ya upasuaji inakusudiwa kuchelewesha kuunganishwa kwa uti wa mgongo. Mifumo ya kukua hutumiwa kwa watoto ambao wana ugonjwa wa scoliosis unaoendelea haraka wakiwa na umri mdogo. Mti wa ukuaji wenye urefu unaoweza kurekebishwa huingizwa katika upasuaji wa kwanza na kisha huongezwa kwa njia ya taratibu za ziada kila baada ya miezi sita hadi kumi na mbili kadiri mtoto anavyoendelea kukua. Wakati mtoto anapokaribia kukomaa kwa mifupa, daktari anaweza kupendekeza kwamba afanyiwe upasuaji wa kuunganisha uti wa mgongo (ikiwa ni lazima). Upasuaji wa uti wa mgongo unaofanywa katika umri mdogo sana (kwa kawaida msichana ni mdogo kuliko miaka kumi na mvulana ni mdogo kuliko miaka 12), hii inaweza kusababisha nafasi kidogo kushoto kwa mapafu kukua kikamilifu na kuondoka mtoto na shina fupi ikilinganishwa na viungo vyao. Ili kuepuka matatizo haya, mfumo unaokua utasaidia kuongoza ukuaji wa uti wa mgongo na kuzuia curve kutoka kwa maendeleo wakati uti wa mgongo unafikia ukomavu na hatimaye unakuwa tayari kwa muungano wa uti wa mgongo (kama inahitajika). - Fusionless (Vertebral Body Tethering (VBT)) <unk> Kwa sasa kuna mbinu ambazo zinahusisha kutumia shinikizo la mara kwa mara kwa mfupa, ambayo, kwa nadharia, itaruhusu kukua kwa unene na polepole zaidi. Wakati curvature nje ya uti wa mgongo ni sasa, daktari wa upasuaji kujaribu kupunguza au kuzuia ukuaji wa curve kwa kutumia shinikizo kwa upande wa nje, wakati upande wa ndani ya curve itaendelea kukua kama kawaida. Hilo huruhusu uti wa mgongo ulindwe kwa muda. VBT inahusisha modulation ya ukuaji na inakusudia kuhifadhi kubadilika na ukuaji kwa kuweka screws upande wa nje wa curve na kisha kuifunga kwa kutumia kamba ili kuelekeza uti wa mgongo. Kumbuka, mbinu hii bado ni mpya na inahitaji utafiti wa ziada na matokeo ili faida na masuala ya usalama kuchunguzwa kwa undani zaidi. Katika kisa cha matineja au watu wazima wachanga, kuunganishwa kwa uti wa mgongo kunabaki kuwa pendekezo la upasuaji wa scoliosis. Upasuaji au braces: Kwa kawaida, vigezo vilivyotajwa hapa chini hutumiwa kuamua kama mtu aliye na scoliosis anapaswa kupata brace, upasuaji au matibabu ya kihafidhina: - Braces hutumiwa mara nyingi kwa watoto ambao curvature ni kati ya digrii 25 na 40 na ambapo mtoto bado ana baadhi ya kukua muhimu kufanya. Upasuaji unaweza kuendelezwa ikiwa curvature ya mtoto ni zaidi ya digrii 50 na haijawahi kutibiwa kwa hali hiyo au ikiwa brace haikuwa na ufanisi. Katika watu wazima, scoliosis kwa ujumla haina maendeleo kwa zaidi ya 40 ° C. Hata hivyo, upasuaji ni wakati mwingine chaguo kama kiasi kikubwa cha maumivu ni sasa au kama scoliosis matokeo katika masuala ya neva. Kumbuka kwamba uchaguzi kati ya chaguzi hizi si rahisi kila wakati na baadhi ya kesi maalum itahitaji kuchunguzwa zaidi ili kutambua chaguzi bora za matibabu. Ni aina gani za wataalamu wanaotibu ugonjwa wa uti wa mgongo? Kwa kawaida, daktari wa jumla au daktari wa watoto ataona matatizo yoyote ya uti wa mgongo mwanzoni, baada ya hapo, atajadili na daktari wa upasuaji wa mifupa au daktari wa upasuaji wa neva ambaye ni mtaalamu wa upasuaji wa uti wa mgongo. Mbali na wataalamu hao, mtaalamu wa kurekebisha tabia au mtaalamu wa tiba ya kimwili aweza pia kushauriwa. Watu wengine wanaweza kuhitaji mtaalamu wa tiba ya kazi au mtaalamu wa neva awe sehemu ya timu yao ya matibabu kwa kuendelea. Mtaalamu wa tiba ya kazi husaidia mtu kurekebisha uwezo wowote wa kimwili ambao unaweza kutokea kwa sababu ya hali hiyo au anapopona baada ya upasuaji. 2. Uwezekano wa kupata Chuo Kikuu cha Maryland Medical Center. Mwaka 2012 Scoliosis (kuvunjika kwa uti wa mgongo) "Kama ilivyoelezwa katika taarifa ya ""Hospitality Health Report"" iliyochapishwa tarehe 7 Septemba 2017." Niams. Mwaka 2002 Scoliosis katika watoto na vijana. "Kama ilivyoelezwa katika ukurasa wa ""Huduma za afya za binadamu"" (Huduma za afya za binadamu, Huduma za afya za binadamu, Huduma za afya za binadamu) katika ukurasa wa 6 wa ""Huduma za afya za binadamu"" (Huduma za afya za binadamu, Huduma za afya za binadamu)."