The treatment of scoliosis

The treatment of progressive scoliosis often involves wearing an orthopedic brace. If the curvature of the spine is very important, surgery may be necessary.

THE GOAL OF SCOLIOSIS TREATMENT

The management of patients with scoliosis is multidisciplinary. It requires the collaboration of different health professionals: attending physician, pediatrician, orthopedic surgeon, rheumatologist, physiotherapist, orthoprosthetic... In case of scoliosis, the main objective of care is to limit the worsening of the deformation of the spine (or "spine"). If it is a child or a teenager, it is essential that the deformation is as moderate as possible at the end of growth. There are several options for processing: simple monitoring when scoliosis has a small curvature, making room for treatment in case of worsening of the deviation, the installation of a brace, surgery. Whatever the treatment, relieve scoliosis pain If the patient feels pain related to scoliosis, analgesic drugs may be prescribed in parallel with care. Adult patients may also benefit from analgesic injections. They are performed under radiological guidance at the different deformations of the spine.

ORTHOPEDIC TREATMENT FOR SCOLIOSIS: WEARING A BRACE

This is the main treatment proposed for children and adolescents when scoliosis is progressive. This medical device is used to maintain the spine to reduce the risk of worsening pathological curvatures. There are different types of braces, used depending on the nature and importance of spine deformations. In any case, the device is made to measure, from a body molding, to be as suitable and as tolerated as possible. Sometimes the patient must wear a cast for one to two months before using the brace, to get a better correction. In the Lyon method, the cast is replaced by the permanent wearing of the brace with corrections made directly on the patient. After the full time, the effectiveness of the brace is directly influenced by the number of hours of wearing it. In a growing young, the brace should be worn at least 16 hours a day until the skeleton has finished growing. In adults, the brace improves pain and the impact of scoliosis on daily life, restores the balance of the spine and slows down evolution.

SURGICAL TREATMENT OF SCOLIOSIS

In case of failure of orthopedic treatment, surgical treatment may be indicated for important scoliosis that continue their evolution. The operation is performed in a specialized center to monitor the functioning of the spinal cord during the intervention by measuring spinal cord evoked potentials. It involves correcting spinal deformities with metal rods attached to the vertebrae. A bone graft is often performed. This treatment requires a preoperative assessment and hospitalization. This surgery can be complicated: infections of the operated area, spinal cord injury. Monitoring of the spinal cord has significantly reduced this risk. Neurological damage, when present after the procedure, usually regresses and neurological sequelae (paralysis of a toe, a leg...) have become very rare.

SCOLIOSIS: WHAT IS THE PLACE OF FUNCTIONAL REHABILITATION?

Physical therapy sessions prescribed for scoliosis have several objectives: maintain spine mobility; maintain respiratory function; strengthen the muscles; work on holding the spine. These treatments are always performed in combination with orthopedic or surgical treatment of scoliosis. In isolation, they would be insufficient to act on the evolution of the curvatures of the spine. In addition, the Lyon method specifically stimulates the postural system.