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Scoliosis occurs when the spine is not only slightly s-shaped, but also curved to the side. While minimal axis deviations are quite normal, scoliosis is by definition present when the curvature angle to the side is more than ten degrees. The bends, in which the vertebrae are additionally twisted, usually affect the entire back: from the cervical spine (cervical spine) over the thoracic spine (thoracic spine) to the lumbar spine (lumbar spine), the spine is not straight.
Scoliosis persists, can not be corrected by the person affected, is usually noticeable in childhood and worsens when no therapy is given. The mobility is limited by the curvature. In severe cases, the heart and lungs may suffer from the bent spine.
The cause of scoliosis is mostly unknown. Up to 90 percent of patients - girls are more likely than boys - have no apparent cause of spine curvature. Inheritably, the disease is not clear, but the risk of developing scoliosis increases when close relatives are also affected.
Depending on the severity of the scoliosis, the curvature causes the sufferer different degrees of discomfort. While a mild scoliosis usually does not cause any problems and at most attracts attention, a severe scoliosis has consequences for the spine and even organs: those affected have back pain and it comes early to wear on the vertebrae. Over time, the malposition worsens and in severe deformation, the heart, lungs, digestive organs and the kidneys may be impaired in their function.
A medical therapy is not required for every scoliosis. Whether treatment should take place depends on the severity, the cause and the age of the patient. For severe scoliosis with Cobb angles greater than 50 degrees, physician, patient, and parent should consider surgery. On the operating table, surgeons straighten the spine and stiffen sections. Like any surgery, scoliosis surgery involves risks. It should therefore only take place if there are no other therapeutic options, severe long-term consequences of the disease threaten and measures such as physiotherapy are exhausted.
|Estimate Costs For Scoliosis Treatment|
|Surgical treatment of scoliosis||from €15,000|
No one likes to operate on the spine. Although back problems are widespread and the number of people requiring back surgery is increasing, many patients are more concerned about spinal cord injury during surgery.
Priv-Doz. Dr. Jan Siewe, Medical Director of the Department of Spine in the Leverkusen Health Center, knows the fears of his patients. As a specialist in his field, he has done countless operations on the sensitive musculoskeletal system, which gives us the upright gear. His field of expertise ranges from classic herniated discs, fractures and pediatric scolioses to tumor treatments and prosthetic surgeries.
For about five weeks now, he has been able to rely on a precise navigation system during the operation in the hospital. "This gives us the opportunity to follow closely on a screen by navigation, at which point in the body of the patient is currently the instrument or a screw must be set," said Siewe the procedure. For this purpose, 3D X-ray images are previously created by the patient while he is lying on the operating table.
The rotating X-ray machine produces 360 shots in 40 seconds, which together provide an exact representation of the area to be operated. These are the basis for later navigation with a kind of pin-shaped miniature camera. This transmits the images to a monitor, which allows a precise, enlarged view of the spine. This gives the surgeon even more security, especially in operations where accuracy in the millimeter range is important.
In addition, diseases such as the treatment of scoliosis (the lateral deviation of the spine), which must be performed at a young age, can be optimally treated. "Many parents and adolescents are afraid to straighten the bent spine," explains Jan Siewe. "Even if you are symptom free at a young age, scoliosis becomes painful as you get older from the age of 30." The even more precise way to operate using computer navigation will hopefully make it easier for parents and children to decide on the spine straightening step.
"I would let my daughter operate," says Siewe convinced. For the hospital, the approximately three-quarters of a million-euro investment to equip the operating room is a further step in specializing in a specialist field.
"With the high-tech navigation device of the new generation, we are pioneers in the region," explains Prof. Dr. med. Leonard Bastian, Director of the Department of Orthopedics, Trauma, Hand and Reconstructive Surgery.
The Klinikum Solingen, with which the Leverkusen house is currently in cooperation talks, do not have such facilities. Even the device in the Cologne University Hospital is older. Nonetheless, the medical profession agrees, this technology will also be used in most operating theaters in the coming years. Then the surgical robot will also determine the future in spinal medicine.
They come from New Zealand, England, Spain, Nicaragua or Greece - the patients of Dr. med. Per Trobish.
The reason: head physician Per Trobisch has successfully completed a new, non-stiffening scoliosis operation since June 2017. This method of spinal surgery is still very new in Germany and Europe and attracts international patients to the Eifel. Especially children and young people benefit from the treatment technique, as it maintains the mobility of the spine.
A non-stiffening scoliosis surgery? Even experienced spine surgeons are surprised. For what chief physician Dr. Per Trobisch in the Eifelklinik St. Brigida offers mainly for his young scoliosis patients is still very new in Germany.
Scoliosis is a curvature of the spine that usually occurs in children and adolescents. Three percent of all girls are affected. If the scoliosis has reached a certain extent, it must be stiffened with many screws and rods. But Dr. Trobisch, who has been working in the Eifelklinik since 2014, uses a special rope that keeps the crooked spine in the right path and sets the direction for growth. "Like an inner corset," explains the chief spinal surgeon in St. Brigida. Although stiffeners are still standard, the new method is on the rise - Dr Trobisch performs two scoliosis operations per week in Simmerath, and thus about every tenth scoliosis surgery in Germany, represents the 40-year-old the importance of the Eifelklinik in this medical Fachbereich out.
She was in constant pain, she could not lean back on a chair and never dance as ballet as she wanted. Alina has a spinal curvature - a so-called scoliosis, due to which her back was postponed. The student was not wearing tight clothes - afraid that someone might stare at her crooked back. For a long time, the 17-year-old looked for suitable therapy with her family. Finally, they decided on a new surgical technique, the Dynamic Scoliosis Correction.
Dynamic scoliosis correction basically works like an inner corset: A flexible plastic rope is attached to the side of the spine with screws, on the outside of the curve. This band is put under tension and is intended to raise the crooked spine gently and minimally invasive. The body of children and adolescents is thus kept in shape during growth. The back remains mobile. Therefore, the Dynamic Scoliosis Correction is especially suitable for young scoliosis patients whose skeleton has not yet fully grown Per Trobisch, who performed the operation at Alina.
Dynamic scoliosis correction has only recently been carried out in Germany. So far, scoliosis patients have been able to stiffen their backs with screws and rigid metal rods, severely restricting mobility, causing individual vertebrae to grow together, and often causing the discs below the stiffener to wear out more quickly. Also, the recovery phase is significantly shorter with a dynamic scoliosis correction with one to two weeks than with a spinal fusion, after the sport is banned for a year.