Scoliosis
Your Personalized Treatment Plan
Do not limit your treatment options only to the nearest hospital.
We offer the most effective, quick and affordable scoliosis treatment,
thanks to the world’s largest hospital network.
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Scoliosis refers to an unusual bending of the backbone, resulting in a curved shape. Normally, the spine has a natural forward and backward curvature while scoliosis causes the spine to also form a sideways curve. The severity of these curves can range from as little as 10 degrees to more than 100 degrees.
Treating scoliosis only becomes more challenging as the condition progresses. Not only is this because the condition is naturally moving into its more severe stage of progression over time, but also because the body has had years to adjust to the abnormal spinal curvature. After a person has been living with scoliosis for years, their spinal discs, muscles, and tendons gradually adjust to the spine’s unnatural position. In addition, a spine that is no longer growing is less malleable and more rigid so early treatment is advised.
Complete Recovery
No Hidden Fees
No Waiting Lists
Leading Surgeons
Scoliosis corrective surgery in the USA costs $120,000 on average. The prices in other European countries range from $15,000 to $50,000 depending on the case and technique used. Private treatment abroad allows you skip waiting lists while at the same time reducing the costs of scoliosis surgery considerably, up to 70% cheaper, in European facilities that are just a short flight from home.
The hospitals listed below are located in countries, known for their excellent development in the private healthcare, with latest equipment and well-trained English-speaking surgeons. Our medical consultants will be happy to advise you for free on the best choice for your scoliosis treatment in one of our leading hospitals.
- Croatia
- Czech Republic
- Estonia
- Hungary
- Latvia
- Lithuania
- Poland
- Turkey
Treatment of Scoliosis
Surgery is reserved for cases of adult scoliosis where non-surgical interventions have proven ineffective or the condition has significantly worsened. The decision for surgery may be based on the following factors:
- Pain: Surgery may be necessary if the back and leg pain caused by scoliosis becomes severe and persistent, and does not respond to conservative treatment.
- Spinal imbalance: The balance of the spine is crucial in assessing scoliosis progression and the need for surgery. When standing, the head should be aligned over the center of the pelvis when viewed from the front and over the hip joints when viewed from the side. If the curve progresses to the extent that this balance cannot be maintained, it can lead to increased pain and functional limitations over time.
- Quality of life improvement: While surgery is not typically recommended solely for cosmetic purposes, some individuals may find the symptoms of their spinal deformity unbearable, impacting their overall quality of life. Surgery may be the only option in such cases. In younger adults, cosmetic deformity may be a significant consideration for surgery, but it is usually less important in older adults.
Orthopedic Braces
Spinal Fusion
Expanding Rods
Vertebral Tethering
Orthopedic Braces
If a child has moderate scoliosis and the bones are still growing, the doctor may recommend a brace. Wearing a brace does not cure scoliosis or reverse the curve, but it usually prevents the curve from worsening.
The most common type of brace is made of plastic and is shaped to fit the body. This brace is nearly invisible under clothing, as it fits under the arms and around the rib cage, lower back and hips.
Most scoliosis braces are worn between 13 and 16 hours a day. The effectiveness of a brace increases with the number of hours a day it is worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, the child can remove the brace to participate in sports or other physical activities.
Scoliosis braces are not longer worn when no further changes in height occur. On average, girls complete their growth at the age of 14 and boys at 16, but this varies greatly between individuals.
Spinal Fusion
Surgeons have performed and refined spinal fusion surgery for decades with a high rate of success.
In a spinal fusion, surgeons connect two or more of the bones in the spine, called vertebrae, together so they can’t move independently and then they heal into a single, solid bone. This stops growth completely in the abnormal segment of the spine and prevents the curve from getting worse.
All spinal fusions use some type of bone material, called a bone graft, to help promote the fusion. Generally, small pieces of bone are placed into the spaces between the vertebrae to be fused. The bone grows together — similar to when a broken bone heals.
Metal rods are typically used to hold the spine in place until fusion happens. The rods are attached to the spine by screws, hooks, and/or wires. Exactly how much of the spine to fused depends upon the patient’s curve.
Most spine fusion surgeries last from 4 to 8 hours, depending on the size of the patient’s curve and how much of the spine needs to be fused. Some of this time is spent preparing the patient for anesthesia, as well as hooking the patient up to various monitors, and positioning the patient to be as safe and comfortable as possible.
Patients may require spinal fusion surgery because:
- They have curves that can get too large for the brace.
- They’re too old and their spines have finished growing.
- They have a type of scoliosis that can’t be stopped with a brace.
Expanding Rods
In cases where scoliosis progresses rapidly during early childhood, surgeons can employ one or two expandable rods along the spine that can be lengthened as the child grows. This adjustment, necessary due to the child’s ongoing growth before reaching skeletal maturity, is made every 3 to 6 months.
These scoliosis rods serve as a treatment for severe scoliosis in young children who cannot undergo spinal fusion due to their age. Unlike adults, children under 8 years old continue to experience growth, contributing not only to their height but also expanding their chest and developing their lungs.
Unlike spinal fusion, devices like scoliosis rods are designed to preserve growth. They allow the child to grow until reaching skeletal maturity, after which a more permanent solution like spinal fusion can be considered.
Before the introduction of minimally invasive scoliosis rods, children with scoliosis had to undergo multiple surgeries to adjust rod length as their spines grew. Modern systems have eliminated this requirement. Some advanced growing devices include:
- Magnetically controlled scoliosis rods (MCGR): With MCGR, the scoliosis rods are implanted only once. Subsequently, an external remote controller is used to expand the rods in accordance with the child’s height changes. The rods contain magnets that can be activated by the doctor using a handheld device, enabling lengthening without incisions.
- Growth-Guided Devices: These devices utilize “anchor points” to attach expandable rods to the spine via screws or wires. As the child’s spine matures, the rods stretch in length due to the growth process. While the rods are rigid apart from vertical expansion, they effectively correct spinal curvature while allowing for growth.
- Vertical Expandable Prosthetic Titanium Rib Device (VEPTR): Severe scoliosis in children and adolescents may require VEPTR to facilitate rib expansion as the child grows. Adequate chest expansion is necessary for lung maturation, and VEPTR serves this purpose. It’s important to note that only specific hospitals are equipped to perform VEPTR procedures.
Vertebral Tethering
Vertebral body tethering (VBT) is a surgical solution for idiopathic scoliosis in growing children whose condition persists despite bracing. Vertebral body tethering leverages the natural growth of the spine to correct sideways curvatures while allowing ongoing spinal development. Vertebral body tethering can be an alternative to spinal fusion surgery and is recommend if the child:
- Idiopathic scoliosis
- Scoliosis curves that are between 40-65 degrees
- Vertebral bodies of sufficient size to accommodate screws
- At least 10 years old and generally younger than 16 years old
- Have significant growth remaining
- Sanders score of 2-5 or Risser 0-3
In this innovative procedure, metal anchors and a flexible tether are attached to the side of the spine exhibiting outward curvature. In contrast to spinal fusion surgery, which involves attaching metal anchors and rigid rods to both sides of the spine, vertebral body tethering is less invasive.
Surgeons affix metal anchors to the vertebrae on the outwardly curved side of the spine. A flexible cord, or tether, connects these anchors and is placed under tension. As the child continues to grow and their spine elongates, the tether slows down growth on the curved side, allowing the other side of the spine to catch up. Consequently, as the child grows, their spine gradually straightens. The anchors and tether are permanently attached to the child’s spine, unless complications arise.
In comparison to spinal fusion surgery, vertebral body tethering preserve greater mobility and flexibility of the spine. Spinal fusion involves fusing vertebrae into a solid bone, creating an inflexible section of the spine that cannot bend or grow beyond its height at the time of the surgery. The rest of the spine that is not fused has to perform additional work, because it has to compensate for the loss of movement at the fused spine; as a result, the unfused spine wears out more quickly and may lead to degenerative arthritis.
Complications of Scoliosis
Complications
Types and Causes
Symptoms
Diagnosis
Complications
If left untreated, the scoliosis can potentially lead to several complications, including:
- Increased pain and discomfort: The spinal curvature can cause strain and pressure on the surrounding muscles, ligaments, and nerves. Over time, this can result in chronic pain in the back and other affected areas.
- Reduced mobility and flexibility: Scoliosis can lead to stiffness and reduced range of motion in the spine, making it difficult to perform daily activities or do physical exercise.
- Spinal imbalance and deformity progression: Without being treated, scoliosis curves may continue to progress and worsen over time. This can result in a more pronounced spinal imbalance, leading to changes in posture and appearance.
- Breathing difficulties: In severe cases of scoliosis where the curvature affects the chest cavity, it can restrict lung expansion and compromise respiratory function. This can lead to shortness of breath and respiratory complications.
- Digestive and cardiovascular issues: Severe spinal curvature can also compress the abdominal organs, leading to digestive problems such as difficulty in eating and digestion. Additionally, cardiovascular function may be affected due to reduced space within the chest cavity.
- Psychological impact: The visible deformity and chronic pain associated with untreated scoliosis can have a negative impact on a person’s self-esteem and psychological well-being.
- Nerve compression and neurological symptoms: In some cases, the spinal curvature can lead to compression of nerves, resulting in symptoms such as radiating pain, numbness, tingling sensations, and muscle weakness in the arms or legs.
It is important to note that the progression and severity of complications can vary among patients and depend on factors such as the degree of curvature, age, overall health, and individual circumstances. Early detection and appropriate treatment can help mitigate these potential complications and improve long-term outcomes
Types and Causes
Scoliosis can be classified into different types based on its causes and characteristics. The main types of adult include:
- Idiopathic Scoliosis: this type of scoliosis develops or persists without a clear underlying cause. It may be a continuation of pediatric or adolescent idiopathic scoliosis or can arise later in life. It often has a genetic or hereditary basis.
- Degenerative Scoliosis: Also known as de novo scoliosis, this type occurs as a result of degenerative changes in the spine due to aging, such as disc degeneration, osteoporosis, or spinal stenosis. It typically affects older individuals.
- Postural Scoliosis: Postural scoliosis is a non-structural type of scoliosis that is caused by poor posture, muscle imbalances, or habitual asymmetrical positioning. It can be corrected by addressing postural habits and strengthening the supporting muscles.
- Secondary (or Neuromuscular) Scoliosis: Secondary scoliosis occurs as a result of an underlying condition or facto and can be associated with factors such as trauma, previous spine surgery, neuromuscular disorders (e.g., cerebral palsy), connective tissue disorders (e.g., Ehlers-Danlos syndrome), or spinal tumors.
- Iatrogenic Scoliosis: Iatrogenic scoliosis is a type of scoliosis that develops as a result of medical interventions, such as spinal surgery, radiation therapy, or prolonged immobilization.
It’s important to note that scoliosis can also be a combination of different types. identifying the specific type of scoliosis helps guide treatment decisions based on the underlying cause and individual needs of each patient.
Symptoms
The most common symptoms of scoliosis is pain and, often, a visible bulge on the back at the site of this pain. Less often, people may experience fatigue, a loss of height, or a feeling of fullness when, in fact, the stomach is empty.
Common symptoms
- Pain: patients with scoliosis often experience pain which may be related to the curve itself or due to compression of the spinal nerves. In some cases, there is also muscular fatigue related pain due to muscles on the convex side working harder to maintain postural balance while the concave muscles are mechanically disadvantaged and cannot function optimally. This results in fatigue, especially after activities on the convex side. When there is a nerve compression, this is called spinal stenosis. Stenosis can generate inflammation in nerves which, in turn, causes in leg pain and numbness or weakness when walking or standing for a long period of time.
- Bulge or deformity in the back: Patients are usually able to point to the site where their back pain comes from due to a bulge that may be visible due to muscle rotation or rib cage rotation. The asymmetry in the trunk as it relates to the pelvis may be very pronounced and also result an inability to stand upright.
Additional symptoms experienced by some patients
- Loss of height (stature).
- Shortness of breath or quick fatigue. This affects patients with large and progressive curves (over 70 degrees) that compress the lungs.
- Premature feeling of fullness in the stomach. This affects people with progressive, thoracolumbar curves (curves that span the thoracic and lumbar sections of the spine). Associated pressure on the abdomen can make a person feel full while eating, even though the stomach is not truly full.
Diagnosis
Early detection of scoliosis is most important for successful treatment. In order to create a treatment plan for scoliosis, your doctor will first need to gather information by conducting a comprehensive history assessment:
- Family history: any instances of scoliosis or spine-related conditions among your family members.
- Onset of symptoms: the date when you initially noticed changes in your spine or related symptoms.
- Pain assessment: presence and location of any pain or discomfort you may be experiencing.
- Neurological symptoms: assessment of any signs of bowel, bladder, or motor dysfunction, as these can indicate potential nerve damage or pressure resulting from scoliosis.
During a physical examination, your doctor will thoroughly examine your back to assess the shape of your spine and observe your range of motion. Additionally, nerve function tests, such as reflex, sensation, and muscle-strength checks, may be conducted.
If necessary, your doctor may require an X-ray. These X-rays, taken from both the front and side angles, provide a comprehensive view of your spine, enabling your doctor to confirm the presence of scoliosis and determine the degree of curvature.
The following additional diagnostic procedures may be performed for nonidiopathic curvatures, atypical curves or congenital scoliosis:
- MRI: this diagnostic procedure uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body.
- CT scan: this diagnostic imaging procedure uses a combination of X-rays and computer analysis technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than X-rays.
Our Leading Specialists
Dr. Cyrill Dennler
15 years of experience. Specialized in interdisciplinary spinal surgery and pain therapy. Member of Swiss Society for Orthopaedics and Traumatology and Swiss Society of Spinal Surgery.
Dr. Fabrizio Giudici
Around 150 spinal surgeries per year. Particularly dedicated to the treatment of adolescent and adult deformities, scoliosis and hyperkyphosis, and to the treatment of degenerative pathologies, such as discopathy and spondylolisthesis. Professional certified by the Spine Society of Europe.
Dr. Jan Matussek
Chief Physician Pediatric Orthopaedics with 35 years of experience. Specialized in conservative and operative scoliosis therapy, ventro-dorsal spondylodesis and pelvic corrections for hip dysplaise in adolescents and adults. Double winner of 1st Prize Medical Orthopedic Technology (2000 and 2009).
Having an experienced doctor evaluate your case individually is an important initial point of your treatment. Thanks to their expertise, professionals can accurately diagnose and assess the unique complexities of each patient’s health condition. Every individual’s medical history, lifestyle, and genetic assets are distinct, making personalized evaluation essential for effective decisions. Sometimes making autonomous decisions may lead to inaccurate self-diagnoses or misguided choices. As our patient, you will benefit from informed guidance, ensuring comprehensive and personalized care that optimizes final outcomes.
