Teens With Spinal Scoliosis?——Things You Should Know

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What is AIS?
What is a Cobb angle, and how is it measured?
What are the hazards of AIS?
How to treat AIS
What is De-rotation of the Spine Surgery?
Selection of Surgical Instruments

With the development of the modern economy, more and more teenagers have scoliosis, which will not only affect their external image, physical and mental health, daily study and life but also affect their growth and development to varying degrees.

Today’s topic focuses on a particular open-spine surgical procedure – the correction of kyphoscoliosis. Before delving into the details of the surgery, let’s first understand what Adolescent Idiopathic Scoliosis (AIS) is.

What is AIS?

The definition of scoliosis by the International Scoliosis Research Society (SRS) refers to the application of the Cobb method to measure the curvature of the spine on anteroposterior X-ray films of the spine when the examinee is standing, with an angle ≥ 10°.

AIS refers to a three-dimensional spinal deformity of unknown cause, which occurs in adolescents aged 10-18, accounting for about 80% of the total number of scoliosis. The prevalence rate varies in different regions of the world, but in general, it is about 2%.

The cause of AIS is not yet clear, so it is called idiopathic. Epidemiological studies have shown that the incidence rate of women is higher than that of men. Patients with scoliosis usually have appearance deformities, such as high and low shoulders, chest and back bulges, and uneven back, which may cause insufficient lung capacity and low back pain in adolescents. At the same time, due to the influence of appearance, it causes psychological barriers, severe deformities and even shortened life span.

What is a Cobb angle, and how is it measured?

The Cobb angle is an important indicator for evaluating the severity of scoliosis. In general, the greater the angle, the more severe the scoliosis. The plates are parallel lines, and the angle formed by these two lines is called the Cobb angle.

What are the hazards of AIS?

① Unsightly appearance: Scoliosis can lead to abnormal shapes such as spinal deformation, uneven shoulders and back, deformity of the chest, and pelvic tilt, and affect the function of activities at the same time.

②Low back pain: The imbalance of muscle strength on both sides of the spine due to deformity may cause back and lumbosacral pain.

③Mental illness: Adolescence is a psychologically sensitive period. Because of worry and anxiety about its physical deformity and possible discrimination from classmates, adolescents are more likely to have secondary psychological problems such as low self-esteem, autism, and emotional disorders.

④ Affect the heart, lungs, and digestive functions: Severe scoliosis and rotation occur in the chest, which may cause atelectasis and small lung capacity, which in turn affects cardiovascular functions; lumbar deformities may lead to abnormal digestive functions.

⑤ Damage to the spinal cord and nerves, shortening lifespan: Dislocation of the spinal cord and nerves caused by deformity may cause paralysis or radiating pain in the nerve root innervated area, causing spinal cord compression symptoms, and severe cases may cause paralysis. Severe deformities lead to damage to the cardiopulmonary, digestive, and nervous functions of children, resulting in shortened life expectancy.

How to treat AIS

The treatment of AIS is mainly based on the individual condition of the patient, including the growth and development status of the child’s bone age, the rotation of the spine, the type of curvature, and the number of vertebral bodies involved, especially various factors such as appearance deformity and trunk balance are used to select a specific treatment plan.

Non-surgical treatment: Mild scoliosis (Cobb angle<40°) can be considered non-surgical treatment (Cobb angle 10°-25° can be observed, Cobb angle 25°-40° recommended brace treatment) in order to prevent spinal side.

Surgical treatment: If the degree of scoliosis is large (Cobb angle≥45°, or≥ 40°, with a progression of more than 5°) in the previous year, surgical treatment is recommended; if the patient has neurological dysfunction, it often requires surgical correction and spinal nerve reduction pressure.

What is De-rotation of the Spine Surgery?

Scoliosis correction refers to the selection of surgical incisions to expose the scoliotic spine at the obvious scoliosis and then choose the anterior or posterior approach for correction according to the type of scoliosis. At present, the most commonly used method is posterior orthopedics.

Select the appropriate orthopedic segment, use pedicle screws and metal connecting rods, and use “translation technology” and “de-rotation technology” to correct curved spinal deformities and maintain normal sagittal alignment. At the same time, the lamina facet joint bone graft fusion is performed to maintain the long-term correction effect while retaining the patient’s activity function to the greatest extent. Using intradermal cosmetic sutures, the incision is long but does not leave unsightly scars.

It should be noted that regardless of adult or not, taking out the internal fixation will cause the recurrence of spinal deformity, so the internal fixation is not taken out after spinal orthopedic surgery.

Selection of Surgical Instruments

If the patient requires surgery. Canwell can provide professional instruments to help doctors and patients get quick and effective solutions. Canwell’s de-rotation devices are well-approved and popular with physicians.