The most common treatment for idiopathic scoliosis is surgery. The most common type of surgery done to correct idiopathic scoliosis is posterior spinal fusion. Another commonly used surgery to treat idiopathic scoliosis is corrective orthosis. There is little evidence regarding effectiveness for other forms of orthosis treatment. Treatment by medical specialists or rehabilitation therapists may also be possible for some people with scoliosis.
The prevalence of scoliosis in the USA is 2% with 50% being asymptomatic. Complications of scoliosis such as spinal deformities are frequent and can cause impairment in daily function, social and occupational productivity, as well as emotional and social adjustment.\n
The first symptom is pain that can radiate down the upper back and spine. Pain can occur as an ache of lower back, hips, shoulders, or neck. This pain usually accompanies other symptoms, especially coughing up blood, shortness of breath, weakness of the lower extremities, and a hunched back with forward sloping shoulders and spine. Other symptoms that occur with a curvature of the spine include spasmy abdominal pain, fatigue, decreased appetite, weight loss, and coughing up, or uncontrollable, pain, which may affect work or other daily activities. Pain is less common in adolescent back pain than in younger children.
In most cases of the most common form, Cobb angle and lumbar lordosis are inversely related, suggesting that there is a fixed curve pattern of the lordosis that is related to the curve pattern. This suggests that scoliosis is an inter-relationship of curve patterns that should not be considered as disease.
The prevalence of scoliosis is greater than the national average for almost all racial/ethnic group; for all races/ethnicities, the prevalence rates of scoliosis are higher among boys, males from the lower income levels, females, and older people (greater than 85 years of age). The prevalence of scoliosis in the adult male population is more than double the rate in the adult female population.
New discoveries are being made constantly about how to treat scoliosis. Many newer systems of care have been tested. The advent of 3D technology seems to be making possible the construction of a 3D database that could be used to predict how a curve will develop in the body. One of the areas of research which is starting to be tested is computerized dynamic and real time surgical planning. This is a very powerful tool because the doctor knows the patient's history and how the patient is reacting in his or her body to different therapies. This type of treatment may become a reality for many patients.
The authors determined whether the Avbt system components can influence bone regeneration or bone remodeling, which can enhance the correction of pediatric scoliosis. Results from a recent clinical trial showed that the Avbt system components could facilitate bone remodeling activity in the coracoid apophysis and lamina as well as in vertebral segments.
Based upon this small series of patients, dynesys components do not seem to affect any particular aspect of bone metabolism, and do not cause any particular risk of side effects. We are also concerned to find that all patients seem well enough during their dynesys treatment that they are not restricted from their normal pursuits and hobbies.
Clinical trials are a cost-effective means of improving patient outcomes but only one trial study included in this research is a randomized controlled study conducted in the US. This trial only had minimal impact on the management of adolescent idiopathic scoliosis. All surgical treatments had similar clinical outcomes. Further, this study showed a statistically significant trend toward higher complication rates in the nonrandomized group (14%). Therefore, additional study is required and there is a need (as for all surgical treatments) to perform trials to determine which patients have sufficient risk and which do not, in order to evaluate their safety and effectiveness.
Avtus was used frequently in conjunction with osteosynthesis and pedicle screw placement with or without decompression. The avtus' application in this context was primarily cosmetic and did not alter pain relieving or outcomes when compared to the control group.
Avbt provides a significant reduction in pain, but no significant change in deformities. Treatment with avbt may be beneficial for individuals with mild, moderate, or severe scoliosis who either cannot be treated with traditional bracing or who choose minimally invasive treatment. However, future larger, prospective studies are needed to evaluate this question.