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Treating idiopathic scoliosis without surgery

Dr. Firas Husban, Consultant Orthopedic Surgeon, Burjeel Hospital for Advanced Surgery

Dubai, United Arab Emirates, 21 September 2022: Over the past 100 years, significant advancements have been made in spinal fusion to treat scoliosis. These advancements have led to improved fusion rates, lower complication frequency, greater three-dimensional correction of the deformity and more rapid postoperative recovery.

However, spine fusions mean fewer motion segments (less spine motion), which may lead to lower function in high-level physical activity and greater chance for spine arthritis. Dr. Firas Husban, Consultant Orthopedic Surgeon, Burjeel Hospital highlights more on how to Treat idiopathic scoliosis without surgery.

Scoliosis is an abnormal lateral curvature of the spine, often diagnosed in childhood or early adolescence. It can develop in infancy or early childhood. However, the primary age of onset for scoliosis is 10-15 years old, occurring equally among both genders. Females are eight times more likely to progress to a curve magnitude that requires treatment.

Dr. Firas mentions that scoliosis can be classified by etiology, idiopathic, congenital or neuromuscular. Idiopathic scoliosis is the diagnosis when all other causes are excluded and comprises about 80 percent of all cases. Adolescent idiopathic scoliosis is the most common type of scoliosis and is usually diagnosed during puberty.

Scoliosis affects 2-3 percent of the population worldwide.Mild cases of scoliosis may not need treatment. But, moderate to severe scoliosis that is left untreated can lead to pain and increasing deformity, as well as potential heart and lung damage

idiopathic scoliosis had three treatment options: monitoring, bracing, or spinal fusion surgery. A new option emerged in 2019 when the Food and Drug Administration approved a treatment called vertebral body tethering (VBT). Compared to spinal fusion surgery, VBT offers quicker recovery times and the potential for greater spine mobility after surgery. VBT is a minimally invasive technique that modulates continued growth without fusion, preserving motion.

Unlike scoliosis braces, which merely prevent curve progression, VBT can actually reverse abnormal curvature. Additional benefits of VBT include the following:

Because a VBT is minimally invasive, it causes very little trauma to the delicate tissues of the back. This leads to less blood loss and postoperative pain and speedier recovery times.

The surgeon accesses the spine through an incision under arm, hence scarring is minimal and easy to conceal. Also VBT uses a fusionless system, so mobility or flexibility in spine is retained so day-to-day activities, even sports is possible.

Dr. Firas mentions that with a VBT, developing Adjacent Segment Disease (ASD) is avoided as ASD occurs when spinal fusion causes the spinal discs adjacent to the fusion site to degenerate.

After surgery, the spinal curve shows improvement and curve will continue to improve as the child grows and the spine adjusts to the tension on the tether. The tether stays in the body unless a problem occurs, such as overcorrection of the curve.

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