What is scoliosis?

Scoliosis is a curvature of the spine, which can be mild or severe. When the curve is less than 10 degrees, it usually doesn’t cause any symptoms, and this is the case in almost 3% of the world’s population. In such cases, no treatment is required. However, when the curve is more pronounced, it should be treated because it can lead to severe health problems. 

There are different types of scoliosis, of which we will point out the following:

Structural or true scoliosis:

Formed by a segment of vertebrae that is pathologically or permanently twisted or rotated.

Functional or compensatory scoliosis:

Formed by a stretch of vertebrae that balance the spine, or compensate, for the curve produced by the really twisted vertebrae.

Causes of scoliosis

Curvature of the spine can be due to various factors:

NEUROLOGICAL PATHOLOGY

CONGENITAL MALFORMATION OF THE BONES OF THE SPINAL COLUMN.

INJURY (ACCIDENT, BLOW...)

PRIOR LUMBAR SURGERY

However, in over 70% of cases, the origin is unknown, for which we use the term idiopathic scoliosis, meaning it has no known cause. 

Main symptoms

The symptoms of scoliosis depend on how pronounced the curvature of the spine is and how long it has been present. Therefore, it is quite common that children do not suffer from discomfort, and symptoms begin to appear after the age of 30, when the curvature worsens. 

The main symptom is pain, which makes the affected person unable to stay in one position for a long time. Apart from this, other more serious problems can occur due to the position of the torso, affecting the heart or lungs. 

How is scoliosis diagnosed at Instituto Clavel?

At Instituto Clavel, the medical diagnosis of scoliosis requires a complete overall examination of the patient. This examination includes a low dose bi-planar X-ray using the new EOS technology, which provides a high quality image which allows the doctor to determine the degree of scoliosis precisely. This test is usually complemented with a magnetic resonance of the complete spine.

If it is decided that the patient has to undergo surgery, the study will also be complemented with a computed tomography of the spine and, in the case of adults, a densitometry to make an assessment of bone quality.
 

How do we treat it?

At Instituto Clavel we offer treatment for children from the age of 10 onwards, and adults. Scoliosis treatment varies depending on the degree of severity. It is possible to choose conservative treatments in the mildest cases, and opt for surgery in those cases where its severity makes it necessary.

In mild cases, at Instituto Clavel we usually opt for specific physiotherapy to strengthen the muscles and the spine, which will help correct the curvature.

When the severity of scoliosis is moderate, apart from physiotherapy treatments, we would recommend using an orthopedic brace. If the affected patient is in the growth stage, the most effective treatment is to wear the brace for 23 hours a day to correct the problem, a use that will gradually decrease.

 

However, when the curvature of the spine is severe and affects the quality of life of the patient, it is necessary to turn to surgery to correct it. For this we have a multidisciplinary team composed of an orthopedic surgeon, Dr. Charosky, who is a world leader in scoliosis surgery, the team of neurosurgeons headed by Dr. Català, the Pain Unit and the ICU team with first-rate critical care physicians.

In addition, we have highly advanced technological equipment including the O-ARM 2 scanner, the Mazor X robot and intraoperative neurophysiological monitoring to make surgery easier and safer. It is important to point out that all this is essential, since scoliosis is one of the most complex spinal surgeries, and it requires the necessary human and technological resources to minimize risks to the maximum.

What is involved in scoliosis surgery?

Scoliosis surgery involves correcting the affected segment by realigning and fusing the vertebrae as necessary. The most common technique is instrumentation through the placement of transpedicular screws, which are then connected with rods to achieve the correct alignment of the spine.

However, at Instituto Clavel, we use less invasive techniques to improve the results of the surgery. The following are some of the key points that make us different. 

1. We begin by making a thorough surgical plan

To do this, we are aided by the low dose bi-planar X-ray imaging equipment called EOS, which allows us to make a precise study of all the angles and shapes of the scoliosis, and in addition, the 3D reconstruction helps us simulate the result of the surgery.

2. We use the latest technology to increase precision and improve results

To ensure the correct placement of the screws, at the Instituto Clavel we use the real-time intra-operative imaging device O-Arm 2, which permits precise placement of the pedicle screws in curves rotated at different angles. Thanks to this, we are able to perform the complex maneuvers needed to align the spinal column without harming it, and the resulting correction is better.

In addition, we use the Mazor X robot technology to improve the planning of the surgery in order to optimize the location of the screw placement even more.

In order to align the spinal column, small cuts call osteotomies are made in the vertebrae. At our center we use ultrasound bone cutting technology which makes it possible to perform these cuts without causing bleeding.

3. We reduce the need for blood transfusions

At Instituto Clavel, we use intra-operative blood salvaging (IOS) making a reserve of the patient’s own blood during the surgery, reducing the need for donor transfusions post-surgery.

4. We monitor the patient during surgery

A neurophysiologist is present to perform continuous intra-operative neurophysiological monitoring (IONM) throughout the surgery, to safeguard the integrity of the spinal cord and other neural pathways.

5. We minimize trauma with staged surgery

At the Instituto Clavel we also practice surgery by stages. That is to say, we may perform a minimally invasive abdominal or lateral approach surgery to help correct the scoliosis prior to performing the posterior approach surgery for placement of screws. We have found that dividing the surgery in separate stages over different days helps minimize the patient’s suffering and greatly facilitates postoperative recovery

6. We have a multidisciplinary medical team

Scoliosis surgery requires a highly specialized, multidisciplinary medical team. At the Instituto Clavel, our team for treating scoliosis includes nurses, physiotherapists, traumatologists, neurosurgeons, and doctors specialized in pain management.

Recovery after the surgery

At Instituto Clavel we believe that a completely personalized rehabilitation, suited to the surgery and the patient, is necessary to get the best results and achieve a swift recovery.

For this reason, we work hand in hand with FisioSpine, a center specialized in spinal rehabilitation, in complex pathologies such as scoliosis. The surgeons and physical therapists work together to develop a plan with specific exercises for each stage of recovery.

Who are the doctors at Instituto Clavel who treat scoliosis?

Want to know more?
Tell us about your case!

Contact us so that we can give you a personalized assessment.

Share on: