How to choose a treatment for scoliosis?

  There are different types of scoliosis, the most common of which, idiopathic scoliosis, is classified as infantile, juvenile and adolescent depending on the time of onset. Other types include congenital scoliosis, neuromuscular scoliosis, etc.  The principles of scoliosis treatment selection: 1, scoliosis less than 25 degrees, should be closely observed; if the annual progression is greater than 5 degrees, and the Cobb angle number is greater than 25 degrees, should be brace treatment.  2, Cobb angle number between 25 degrees and 40 degrees, should be brace treatment, such as annual progress greater than 5 degrees and Cobb angle greater than 40 degrees, surgery should be performed.  3, scoliosis greater than 40 degrees, if the patient is immature, the chance of progression is greater, surgery should be recommended; for patients with mature development, if the scoliosis is greater than 50 degrees and the follow-up finds that the scoliosis has progressed significantly, surgery is also performed.  Strategies for selecting surgical approaches: Depending on the type of scoliosis, the surgeon may use different surgical approaches. Usually fusion surgery is chosen, which can be performed from the anterior or posterior back. The surgery uses instruments to correct the deformed spine and then performs a fusion of the intervertebral space or posterior spinal implants to obtain a stable spine. In adolescent patients, the correction rate is generally about 60-70% due to the flexibility of the spine, while in adult patients, the correction rate is generally about 50% due to the stiffness of the spine. Thus, the residual degree of scoliosis after correction is different for patients with different degrees of scoliosis. In addition, some distal complications may occur at the proximal and distal junctional areas of the endophyte after surgery due to the strong orthopedic forces of the instruments used during correction. In addition, for children with scoliosis who are still growing and developing, the degree of deformity is large, and it is important to correct and control the progression of the deformity while creating conditions for further growth of the spine and the potential of the body’s own regulation. The concave side retains the ability to grow thus dynamically correcting the spinal deformity.