☆ Q: What should parents do if they find that their child’s spine is not straight? A: Parents should be alert to the possibility of scoliosis if they notice asymmetry in the shoulders or low back. You should take your child to the hospital to have an X-ray of the spine to determine if there is scoliosis. If scoliosis is present, a doctor should measure the angle. ☆ Q: If scoliosis is true, how should it be treated? A: Generally speaking, scoliosis within 20 degrees only requires exercise and regular X-ray observation; scoliosis between 20 and 40 degrees requires exercise and brace treatment; and if it is more than 40 degrees, surgery should be considered for correction. ☆ Q: I heard that some hospitals do massage traction and other conservative treatment, the efficacy is reliable? A: Scoliosis correction is not recommended to try yoga, massage, ☆ Q: What are the types of corrective surgery for scoliosis? A: We often refer to corrective surgery is corrective fusion surgery, corrective fusion surgery is the body into the metal nail bar stent, the metal stent can straighten and maintain the curved spine, equivalent to the metal brace placed in the body. It is not enough to rely on the stent alone to maintain the spine, but at the same time, bone grafting is also performed, which means that granular bone is placed on the dorsal side of the spine, which will hold the spine in place after it heals, just like welding the spine in place. Therefore, the metal brace actually loses its role in supporting the spine about six months after surgery, and the maintenance of the spinal curvature then depends mainly on the fused granulated bone. In addition to corrective fusion surgery, there are some special types of scoliosis surgery, including hemivertebrectomy, growth bars and minimally invasive navigation surgery. ☆ Q: What does hemivertebrectomy mean? A: Hemivertebrae means half of a vertebra. It is the most common form of congenital scoliosis. Normal vertebrae are symmetrical on the left and right side, while hemivertebrae are only on the left or right side, and the other side is not growing out. Our spine contains 7 cervical vertebrae, 12 thoracic vertebrae and 5 lumbar vertebrae, with one vertebrae falling on top of the other. If there is an asymmetry in one of the vertebrae, it will affect the overall shape. A hemivertebrectomy is the removal of this abnormal vertebra, which is then fixed with a staple, and then removed after 2-3 years to complete the treatment. ☆ Q: What does a growth bar mean? A: Growth rods are used for early onset scoliosis, which is when the scoliosis becomes apparent before the age of 10. Children before the age of 10 should not have corrective fusion surgery because once the corrective fusion surgery is done, the length of the child’s trunk is fixed, and the trunk of the child at this age has growth potential until the age of 18, so premature fusion will result in a loss of height, and because the lower extremities are still growing, the ratio of the trunk to the lower extremities will be higher in adulthood. The ratio of the trunk to the lower extremities can also be out of proportion. To address this problem, doctors have developed the growth rod technique. This is a surgical procedure in which a metal stent is placed through three small incisions in the upper and middle of the body. This metal stent corrects scoliosis and allows for a minor surgery to lengthen it every year. This buys the child valuable time to undergo the final corrective fusion surgery after the child is 12 years old, greatly improving the outcome. ☆ Q: What about minimally invasive navigational surgery? A: Minimally invasive navigation is a breakthrough achieved in recent years. It is based on the latest navigation equipment, combined with innovations in surgical techniques, and requires only three 5 cm incisions to complete a surgery that previously required a 40 cm incision, for acquired scoliosis of 90 degrees or less. Previously, scoliosis orthopedics was considered to be a highly invasive and risky procedure. The advent of navigation devices has significantly changed this situation. First of all, traditional surgery is very invasive because the spine has to be clearly exposed before the screws can be placed, because traditional surgery relies on anatomical landmarks and the surgeon’s experience to place the screws. Navigation surgery is not necessary because it relies on intraoperative CT to place the screws without looking directly at the anatomical landmarks of the spine, thus greatly reducing the incision and the damage to the back muscles. In the past, spine surgery was considered high risk because of the density of nerves and blood vessels near the spine. The advent of navigation devices has greatly increased the safety of surgery, as it is clear on the navigation screen where the blood vessels and nerves are, and the chance of injury to the vessels and nerves is greatly reduced. Therefore, the use of navigation makes scoliosis surgery less invasive and safer. In addition, minimally invasive navigation can also correct cervical scoliosis, because navigation can place the cervical arch nail, which was difficult to do before without navigation, so cervical scoliosis can also be corrected. Traction or Chinese medicine treatment. These are not based on science. Thousands of years ago in Greek medical books can be seen in the traction bed orthopedic bed treatment scoliosis, but after thousands of years of verification, these simple treatment concept has been proven ineffective and eliminated. In recent years, a large number of patients have also tried and proved ineffective, and currently all public tertiary hospitals in China do not do this treatment for this reason. Only some private small and medium-sized hospitals still do these treatments, but often for commercial purposes and with very limited results. Some small hospitals in Beijing, for example, do conservative treatments for scoliosis, which have proven to be fraudulent. Some hospitals claim to have more than 20 patents, but they are also false propaganda. They even show foreign patients on the Internet, but they are actually a few foreigners posing for pictures. I hope that patients and parents who have the ability to discern will not be fooled again. ☆ Q: Do you not need brace treatment within 20 degrees? A: The correction effect of brace is proportional to the degree of scoliosis, the greater the degree, the greater the correction space of brace. If the degree of scoliosis is less than 20 degrees, the corrective effect of brace is limited and may restrict the development of the child’s thorax, so it is better to wait until the degree of scoliosis exceeds 20 degrees before considering brace treatment. ☆ Q: If I don’t wear a brace but just take pictures regularly, how often should I take pictures? A: If the child is at the peak of development, i.e. 10-13 years old, it should be taken every 3 months, and after 13 years old, it can be taken every 6 months. Q: If the degree is 20-40 degrees, what is the brace treatment? A: Brace treatment must be customized by a professional technician, don’t simply buy a back brace, back brace is to correct habitual hunchback, it is useless for the real scoliosis. The brace must be worn 20-22 hours a day, including sleep, only when bathing, sports can not wear. As the child grows in height, the brace needs to be replaced once a year. Girls should generally wear the brace for at least 2 years after menstruation. ☆ Q: What are the precautions for brace treatment? A: After the brace is done, we should take pictures to see the effect of brace correction, and we should take pictures after wearing it for 1 hour, the effect is the effect of brace correction at this time, and we can also feel whether the brace is suitable or not, if we feel uncomfortable, we can ask the technician to adjust it. In the past, some patients reflected that they had the brace done in other hospitals and put it on, and did not take the film to see the effect. This is a very bad idea, imagine if the brace does not work well or does not work at all, then it is a year of wearing it for nothing, and the child suffers a lot. If you take a review every other year, you need to take off the brace 4 hours in advance, so that it can truly reflect the current prescription. This is because the prescription will bounce back after the brace is removed, but each person has a different prescription. ☆ Q: If the degree is 20-40 degrees, what does the exercise therapy include? A: Exercise mainly includes lateral bending, swallow flying and swimming. Lateral bending is suitable for “C” shaped (single bend) scoliosis, but not recommended if it is “S” shaped (“S” shaped refers to both thoracic bend and lumbar bend). Bend in the opposite direction of spinal curvature to counteract scoliosis. 50-100 per day, in 2-3 sets to complete. Swallow fly, can exercise the back muscles, increase soft tissue balance, 50-100 per day, in 2-3 groups to complete. As for swimming, freestyle and breaststroke are both available. 600-1000 meters per day. Some people also recommend hanging bar, but it is difficult to adhere to, the girl’s own strength is small, can not do a few groups per day, the effect is difficult to guarantee.