Scoliosis in Children and Solutions for Scoliosis
Novel Surgical Method in Spinal Curves
Spinal curves may result in various health problems if not treated. A novel treatment method applied during surgery prevents repeated operations in growing children, and the psychological collapse that they may cause.
Operations are A Cause of Psychologic Collapse
When we consider that the treatment of a child who began treatment at age 3 will continue until age 12, this means a total of 22 operations. Clinical studies have shown that repeated operations create significant stress on children and their families (posttraumatic stress disorder) and cause psychologic problems. The external growing rods technique prevents repeated operations and the problems that may cause. This method can be applied only to growing children and provides advantage in the treatment of curves in growing children. Although this system is considered possible to replace braces in adolescent scolioses, Professor Ahmet Alanay underlines the fact that the system has not been yet tested on adolescent curves.
Scoliosis, which is a sideways curvature of the spine, may result in very significant health problems if it is not treated. Professor Ahmet Alanay, who is a faculty member in Istanbul Bilim University Medical School Department of Orthopedics and Traumatology and also a Executive Board Member of European Spine Society, stated that efficacy of the frequently used brace treatment is controversial and its application to the right patient is crucial. Dr. Alanay also stated that "What is expected from brace treatment is not complete correction of the curve, but rather halting its progression and elimination of the need for surgery", and he emphasized that surgery is the only method with a proven efficacy in the correction of scoliosis. However, it should be known that surgery may have negative outcomes, and it cannot be applied to all patients with scoliosis.
The Child's Spine Must not Remain Short
Curves exceeding 40 degrees in the back or lower back of growing children necessitate surgery, since these curves will result in significant health problems in adulthood. Surgery is also recommended in adults who have totally or almost totally completed their growth and have curves above 50 degrees in the back and 40 degrees in the lower back. The fusion procedure which means fixation of the spine, elimination of movement and termination of growth, should be avoided to prevent a short spine in growing children, according to Dr. Alanay who also states that "If brace treatment cannot stop the curve, the curve needs to be corrected with screw and rod systems placed into the child’s spine and without the fusion procedure" This method named "growing rods system" works like a brace placed under the skin. However due to continuing growth of the spine, the curve will continue its progression despite the implanted rods. Therefore, these rods are lengthened with operations carried out every 6 months, and the curve needs to be corrected again."
Growing Rods Become Savers
Alanay also states that fusion of the spine should be applied when growth has decreased or stopped, and he underlines that the application of this method is very risky when performed with growing classical rods. In this method, special rods implanted into the spine are lengthened in a controlled manner using an externally created magnetic field and without the need for reopening the spine. Thus it provides control of progression of the curve with periodic lengthenings using rods placed the into the spine by a single operation rather than repeated surgeries. In other words, although this method does not provide a surgery-free treatment of scoliosis, it saves small children from frequently repeated operations. Lengthening procedures can be applied in office settings without the need for anesthesia.
No More Unnecessary X Rays!
Professor Ahmet Alanay stated that "Progress has been made in recent years regarding the discovery of what causes scoliosis. One of the most important advances is the demonstration of melatonin deficiency as a possible cause. The second is the discovery of numerous genes which can be responsible for scoliosis." Another innovation with ongoing pilot studies is the determination of the types of scolioses that will progress against those that will not using the genes responsible for scoliosis, Dr. Alanay also says that "Thanks to the progress in these studies, unnecessary X rays and brace applications will be prevented. From a surgical standpoint, the development of externally growing rods means elimination of spinal flexibility and movement with much smaller interventions. It is believed that scoliosis can be treated with a method that resembles correction of crowded teeth with wires.
Sports Does Not Prevent Scoliosis
According to Professor Ahmet Alanay, "There is no scientific proof that shows sports prevents, corrects, causes or worsens scoliosis" Nevertheless, sports discipline gained during childhood is necessary for all children no matter they have scoliosis or not. "Making a child with scoliosis participate in sports is better than doing nothing" is stated by Professor Alanay, who also recommends to avoid keeping expectations from sports not too high regarding benefits on control or correction of scoliosis. He also recommends families to guide their children into a sports type which will increase the physical condition and also will be favored by the child.
Who Should Use a Brace
Brace treatment is applied only to children with remaining growth potential and having curves between 20-40 degrees. Success rates are significantly lower in curves above 40 degrees. Brace treatment is especially discouraged in adolescents who have curves greater than degrees stated above. Prof. Ahmet Alanay states that "The child who will undergo brace treatment should have definitely completed the growth process. The brace should be applied for at least 20 hours a day, and ideally 23 hours.