Scoliosis & Kyphosis
Crookedness of the spinal column – it’s a question of the correct treatment
It can sometimes be determined from the very first glance during childhood. Other times, lateral crookedness of the spinal column with twisting (scoliosis) or lateral bending of the spinal column (kyphosis) is first discovered during puberty.
The spinal column, the central supportive and movement organ of the body, has a set structure. It is precisely designed, whether looking from the front or from behind. If the frontal plane of the precisely put-together spinal column becomes crooked or bent, pain can occur during everyday movements.
Causes & Symptoms
A crooked back with twisting when viewed from the front or from behind (scoliosis) often occurs in childhood or adolescence and involves the lateral bending of one or more sections of the spinal column. This can clearly be noticed when looking at the back from behind. The spine twists around its own axis. There is typically also a deviation from the normal profile of the corresponding spinal column segments when viewed from the side. Scoliosis may occur in the thoracic or lumbar spine region. But it can also develop in both regions or connecting regions. Scoliosis can never be fully straightened out, actively or passively. In the advanced stages, the affected section becomes more and more stiff.
Scoliosis often occurs alongside kyphosis (a “hunched back”). This involves lateral bending of the cervical, thoracic or lumbar spine. However, it can also affect the full spinal column.
In the initial stages of scoliosis or kyphosis, only a few of those affected have physical complaints. However, it is crucial to identify the start of scoliosis or kyphosis: the earlier idiopathic scoliosis or kyphosis occurs, the more this incorrect growth progresses.
Conservative treatment or scoliosis surgery or kyphosis surgery – both are possible
The choice of a suitable treatment method depends on the severity of each individual spinal column crookedness or bending. But the causes, age of the patient, predicted disorder progression and especially what age it occurred also greatly influence treatment.
At Schoen Clinic, we offer conservative and surgical treatments. Even when conservative measures have failed – the scoliosis or kyphosis has progressed despite physiotherapy and corset treatment – there’s always the possibility of surgery. The goal of all measures is to not only prevent the scoliosis or kyphosis from progressing, but also to realign it and keep the spine in its correct position in the long term.
Conservative treatment methods
Conservative treatment: physiotherapy for mild scoliosis
Most often, mild scoliosis has a misalignment of up to approx. 20 degrees. When children are affected, the disorder only rarely advances during growth. In these cases, we recommend physiotherapy with targeted and straightening exercises, i.e. scoliosis-specific physiotherapy. You can strengthen all of your back muscles to combat further crookedness. This also stabilises the muscles.
Conservative treatment for scoliosis: corset for children
For children with scoliosis, the most effective conservative treatment is a corset worn until growth stops. For adults, corset treatment is no longer possible or useful. However, you are not considering surgery, corsets can alleviate pain through their stabilising function.
Conservative treatment for kyphosis
If weak back muscles have triggered the kyphosis, you can often improve your posture and symptoms through physiotherapy. Through special exercises, you can then strengthen your back muscles and stretch your chest muscles. If therapy starts early, wearing a growth-adjusting corset can also be beneficial.
Surgical treatment methods
Scoliosis: surgery procedures
Our surgeons will consider whether surgery is necessary or beneficial for each patient individually. In scoliosis surgery, the spinal column is corrected and permanently stabilised in its corrected position using metal implants, typically using a screw-rod system. This reinforces the treated spinal column section. During the operation, the spinal cord function and nerves are constantly monitored to guarantee the highest levels of safety.
At the end of scoliosis surgery, highly effective pain therapy is always conducted for the first few days after the procedure. Afterwards, stability is normally high enough that gypsum or corseting is no longer needed. Under the guidance of our physiotherapists, you will then begin movement exercises and should be standing and making your first steps as early as the first day after surgery. As soon as you can safely stand, walk and climb stairs, you can leave the hospital.
Kyphosis: surgery procedures
For kyphosis, surgery is only necessary in extreme cases. It’s also only an option for adults, after growth has stopped. Through different surgical procedures, we can prevent kyphosis advancing, recreate normal form and axis relationships and therefore rebalance the spinal column.
In the procedure, we don’t just stabilise the straightened spinal column segments – we also secure the underlying nerve structures. Modern implants and surgical techniques keep the two or three affected vertebrae in a good position until they have been reinforced. Afterwards, the spinal column can fully bear weight again.