MANAGING COMPLICATIONS
OF SCOLIOSIS

СONSERVATIVE TREATMENT OF THE
DISEASES, WHICH DEVELOP AS A
CONSEQUENCE OF SPINAL DEFORMITIES

 

ANALYSIS OF SHORT- AND LONG-TERM RESULTS OF PRACTICING THE PROPOSED TREATMENT METHOD OF SPINAL DEFORMITIES AND PAIN ALLOWED US TO CONCLUDE THE FOLLOWING:

 

In a significant number of patients with idiopathic scoliosis of 1, 2 and even 3 degree and rib hump, long-term use of shoe insole (1,5-2 years) led to correction of the lateral curvature of the spine and complete or significant reduction of the rib hump.

The proposed treatment method gave perspective to treat patients non-surgically and in many cases without braces. The treatment should be initiated as early as possible (e.g. from the age of 1 – 1,5 years); it prevents progression of the spinal deformity and is also effective for prevention of Perthes disease in children, as well as deformities of large joints in older age. Moreover, it improves the effectiveness of treatment of plano-varus and -valgus foot deformities.

Of great importance is the fact that even in cases when patients complained of knee or hip pain caused by varus or valgus deformities and osteoarthritis, use of the orthopedic insole on the side of leg shortening slowed down the process of further disease progression and caused significant reduction of pain in the lower extremities.

The instability of lumbosacral vertebrae causing neural injury to the neural plexus was the cause of varicosis of veins of the lower extremities and even trophic ulceration of the feet, persistent pelvic pain, fibromyalgia, etc. Orthopedic insole increased treatment effectiveness of these diseases and in combination with all other components of the proposed treatment led to restoration of spino-pelvic balance and resolution of the lumbosacral instability.Among our patients were people who have undergone total hip or knee replacement surgery for deforming osteoarthritis, which was usually more pronounced on one the side of the leg shortening and its maximal varus or valgus deformity. However, the pain persisted after these surgeries. We effectively treated persistent pain by eliminating pelvic misalignment using orthopedic insole and thereby ensuring equivocal load on surgically treated joints. The reader should however not forget that dysplasia of lumbosacral motor segment L5/S1 and particularly common rotation/dislocation of the L5, S1 and S2 (due to lumbalisation of S1 and even S2) plays important role in the development of this syndrome.

No matter how difficult may the clinical picture of widespread pain syndrome appear, you can be sure that the leading ultimate cause of the disease was shortening of the leg persisted throughout the patient’s life, which caused disruption of the spinal-pelvic balance and subsequent development of pathological conditions described above.

Long-term treatment results were studied after 10-12 years of follow-up. It was found that the symmetry of spinal erectors have persisted in all patients of all ages, who have regularly performed detorsional correcting exercises. However, there were cases of impairment of the symmetry of trunkal muscles after injuries, falls from height, sudden lifting of heavy objects, self-cessation of exercising, leading to recurrence of scoliosis. In such cases use of orthopedic insole as a repeated treatment course led to correction of spino-pelvic balance and correct the axis of the spine.

Hundreds of thousands of people around the world undergo lower-extremity total joint replacement; millions suffer from joint and spinal pain. The place of adults prematurely dying of numerous diseases would be replaced by a new generation of children and adolescents, which would have the similar fate as their parents. But it appears that we can break this “vicious circle of problems” due to well-organized preventive work of orthopedists.

Improving the health of children, preventing various diseases and greatly helping in the treatment of existing diseases (visual, hearing and speech impairments, allergy, asthma, diabetes mellitus, obesity, etc.) – in this way we would be able to create a new healthy generation of citizens of our countries. For this we do not need large amounts of money, but what we need is the proper organization of preventive and therapeutic measures by health authorities and of course real intention of state leaders to organize a population health improvement program. In this program, significant place should be given to baby carriages and bicycles of new generation, as we have mentioned earlier.

Large amounts of money and efforts are spent on the treatment of patients disabled due to joint pathologies and various diseases of children and adults. We think that prevention of these diseases is much cheaper, easier, and most of all, promising and should be carried out by orthopedists in close collaboration with pediatric orthopedists, pediatricians, neurologists, endocrinologists, psychiatrists, ophthalmologists and other specialists.

EFFECTIVENESS OF THE TREATMENT

The amount of time to correct functional scoliosis varies from a few months to
2-4 years or more, depending on the patient’s age, degree of the leg shortening and the presence or absence of dysplasia of lumbar and sacral vertebrae. During this time a slow remodeling of the bony spine takes place with no external influence. Such self-correction of the vertebral bodies and ribs on the background of the correct posture is definitely faster in a child, beginning from the early childhood till the completion of skeletal growth. Very important is the fact that this process occurs only in the case of the preservation of equilibrium in the lumbosacral motion segment against the background of proper biomechanics of the body

Restorative processes in adolescents and adults with structural scoliosis (in already formed skeleton with structural defects of vertebral bodies, arches, processes and ligaments) take place very slowly within 2-5 years and nevertheless the treatment proposed by Professor Serdyuk leads to correction of scoliotic posture, relief or even resolution of spinal pain and improvement of overall health. But at the same time a significant correction of the deformed bony spine can not be achieved. In such cases surgery is recommended, which includes fixation of the spine with metal implants in maximally correct position and resection of rib hump.