SCOLIOSIS & Scoliosis treatment
My Child has scoliosis. How do get scoliosis treatment with Dr Sarup?
Please do not panic. The first step is to take an appointment. You must bring all medical records and imaging studies (X-rays, MRI, etc.) with you. Please write down a list of questions that you might want to ask. There is information on this page that might answer all your questions.
You/your child will meet Dr. Sarup and his team members in the clinic.
The physical examination usually includes an assessment of the spine, trunk balance, cosmetic deformity, a neurological examination, and a check for any other associated anomaly. Height and arm span measurements will be carried out at this visit, and growth charts will be made. A standing radiograph (X-ray) of the whole spine will be carried out. Clinical photographs will be taken for maintaining patient records.
Scoliosis treatment without surgery in India is an option explored thoroughly for eligible patients. A plan will be formulated at this point. Children with scoliosis may also experience hip-related issues due to uneven weight distribution. Understanding the symptoms of hip problems in children can help in early diagnosis and better management of spinal deformities.
Additional tests will be ordered as a part of a comprehensive assessment. An MRI whole spine, a blood test, ultrasound scan of the abdomen, and a cardiac ECHO are usually done.
All patient data will be filed securely. Any patient-related information will be shared only after due consent from the patients or their carers.
While every effort is made to treat scoliosis non-surgically, the final plan of treatment depends on age of the patient, severity of the scoliosis, scoliosis type, and the physical condition of the patient. Specialists play a crucial role in managing complex cases like scoliosis effectively.
Scoliosis treatment without surgery- India / (Medical Treatment for scoliosis)
Observation and exercises
When the curve is small (10-15 degrees), only observation is needed. Most children fit into this category when they are detected early. We start the patient on specialized exercises (physical therapy for scoliosis). Close monitoring is carried out with x-rays at regular intervals till end of growth. Sometimes, scoliosis treatment for adults also involves Schroth Physical therapy exercises, even in large curves.
4-year-old child with mild scoliosis. Mild Scoliosis treatment takes form of bracing and exercises.
Cast application
Very young children may develop progressive curves. In these children, surgery is not an option. However, young children with flexible scoliosis respond well to cast applications. Casts provide an effective non-operative treatment for scoliosis at this age. Contrary to common perception, children tolerate casts very well.
We offer this scoliosis treatment between ages 1-4 years in a child who has a progressive scoliosis. The cast application is carried out under General Anaesthesia. This casting system follows a special technique of Elongation De-Rotation and Flexion of the spine. The casts are repeated every 4 months. Many children respond very well to this technique with a measurable reduction of the scoliotic curve. This is followed up with bracing and exercises. Spinal deformities like scoliosis can impact growth in children.
Non-operative treatment of Scoliosis with cast showing pre-casting curve D7 to L1 of 74 degrees. After the first cast, the curve reduced to 24 degrees. Serial casts are applied under anaesthesia to obtain scoliosis correction.
Cast precautions
Please see the cast precautions section in out parent / career education section.Bracing
Bracing is suitable for mild- moderate curves in a growing child. Braces have to be worn for 22 hours every day. These are removed for exercises and for bathing. Braces are usually continued till the end of growth. The aim is to restrict the spinal curve to less than 30 degrees thereby avoiding surgery. The braces do not cure scoliosis, but prevent the curve from progressing.
11-year-old female with 30 degree curve, reduce to 90 degree in brace. After 15 month of bracing, curve seen to have reduced to 17 degree without any brace.
At our centre, we advise a Cheneau-Gensingen type of brace. The brace is individualized to each child. Our highly experienced orthotic service providers for scoliosis and other spinal deformities make customised braces for each child/ adolescent.
Cheneau-Gensingen Brace
Physical therapy for Scoliosis
At our clinic, we offer therapy based on Schroth therapy in India. This physical therapy method for scoliosis is highly effective in growing children and also benefits adults with scoliosis.
The child is closely monitored for an increase in height, curve flexibility, and improvement with scoliosis therapy in India for the curved spine. Radiographs are ordered every 4-6 months to monitor curve progress. Non-surgical treatment (medical treatment for scoliosis) needs a lot of cooperation from the child. The effectiveness of bracing is directly proportional to the hours a brace is worn each day. Due to our extremely hot weather 9 months in a year, it is difficult for children to carry out bracing for long hours.
However, successful conservative treatment for mild scoliosis and moderate scoliosis means that surgery can be avoided totally, or the amount of surgery is vastly reduced compared to no treatment.
Operative treatment
What is the best treatment for scoliosis?
While most children are treated by non-operative methods with follow up maintained till the end of growth, there are situations when surgery is required:
Early onset scoliosis
Sometimes scoliosis presents early in life, and does not respond to conservative methods like casting, brace application. These children develop severe large curves which need surgical interventions. However, these children are very young with a lot of spinal growth still to happen. The following surgeries are offered at our clinic for these patients; Spinal deformities like scoliosis can impact growth in children.
Growing rod surgery
This is a fusionless method of correcting the spinal curve and allowing growth of the spine. The rods are fixed to the bent spine surgically. The rod placement allows substantial correction. Subsequently, every 6 months, a small operation is carried out to lengthen the rods and allow growth of the spinal column. This process is carried on till age 10-12 years. A final fusion with screws and rods is carried out at that stage.
Early onset scoliosis at 1 year, treated by casts and then brace. He progressed to a 70-degree curve by age 4 years at which point growth rods surgery was done.
Age 9 years 7 months. Growth rods have been expanded several times. Now has excellent correction. Curve 18 degrees
Magnetic Growing rod surgery
Magnetic growth rods are the latest innovation in scoliosis surgery. Here, the process is similar to growth rod surgery for the first operation. These adjustable growing rods are inserted similarly and allow for correction of the curve. Subsequently, the magnetic rods are elongated without surgery by placing an external remote controller device on top of the skin and keying in a correction length. The corrective elongation of the rods happens automatically inside the body. This avoids the need for repetitive surgery and problems associated with multiple operations. Spinal deformities and mobility issues often overlap in pediatric conditions.
13-Year-old with a 50-degree D7 to L1 Curve
Surgery Of Moderate & Severe Scoliosis
Curves over 50 degrees often need surgery. Usually, surgery is recommended towards the end of spinal growth. The decision to operate and the timing of it is unique to every case. The goals of surgery are to prevent further progression of the curve and achieve a degree of curve correction. Screws are placed in individual vertebrae and connected with rods. The corrected spinal curve has bone material added to it so that the vertebrae can fuse with each other. The magnitude of surgery depends upon the severity of the spinal curve. For very severe curves, 2-stage surgery is required.
A patient usually spends 5 to 10 days after surgery in the hospital. Subsequently, we encourage physiotherapy and the use of a brace for 3 months. The brace is worn during out-of-bed activity. Patients return to normal activities after 3 months of surgery.
Scoliosis surgery is a major operation. It has risks of neurological damage. This risk is approximately 1% in idiopathic scoliosis. We minimize this risk by offering neuromonitoring during surgery. By neuromonitoring, we are able to prevent neurological injury in most patients.
Infection is the other major risk. The incidence in our centre is 1%. To minimize this problem, we conduct our surgery in laminar airflow operating theatres, use standard antibiotic prophylaxis, and carefully perform the surgery by modern aseptic methods.
We like to optimize patient care and prepare the patient for surgery. The steps we take include prescribing an aerobic exercise schedule, high protein intake, and supplements. For patients opting for scoliosis treatment without surgery in India, these preparations also help in recovery and rehabilitation.
We encourage autologous blood transfusion wherever possible. In this system, an adolescent donates his or her own blood once a week till 3-4 units of blood are reserved. These are then used during surgery. This type of blood replacement is advantageous in many ways, since there are no minor transfusion reactions, and the blood demand of a patient is drastically reduced.
Here are some examples of our operated cases:
Before Surgery 11-year-old with D3 to D10 117-degree curve
After Surgery - Excellent correction, Balanced Spine
Here is one more example of our patients who underwent Surgical correction of severe curves
Before surgery
After surgery
14-year-old female with severe scoliosis before surgery left side & after surgery right side on x-rays and spine deformity.
Before surgery
After surgery
There is more information given in the FAQ
(Frequently Asked Questions) section below.
What is Scoliosis?
The spine is made up of small blocks of bone stacked up on each other. These are called vertebrae.
When we look at spine from the front, it has a straight shape.
A diagnosis of scoliosis is made when there is a sideways bend in the spine. The side bending should be more than 10 degrees in order to be called scoliosis. Minor curvatures less than 10 degrees are quite common but are not called scoliosis.
X-rays of 13 year old female with 8 degree curve on AP film. The child is 13 years and towards end of growth. This much curvature is normal.
Small curves in the spine are hardly visible.
Larger curves are quite visible from the back especially when the patient bends forward.
What are the 3 types of scoliosis?
Congenital scoliosis
Scoliosis is caused by abnormal shape of the vertebrae or defects in the spine which are present at birth. This type of scoliosis is visible and detectable early in life. It tends to get very severe with growth.
Neuromuscular Scoliosis
This is caused by disorder of the nervous system – such as Meningo-Myelocoele and Cerebral Palsy. It can also result from muscle abnormality like Muscular Dystrophy. There are many other causes of neuromuscular scoliosis.
Idiopathic Scoliosis
This is by far the most common type. In this type, there is no clearly detectable cause. Genetic factors are often at play in this group of patients. This is most commonly detected after age 9 years.
How common is scoliosis?
Scoliosis is quite common! It affects 1-4 % of the population. Most people have small curve severity that do not require treatment. 1 in 10 cases develop a spinal curve that needs treatment.
How effective is scoliosis surgery in India?
Scoliosis surgery in India is highly effective and affordable, performed using advanced techniques like spinal fusion or rod fixation to correct severe curves and improve posture.
Can scoliosis get worse as you age? / What can worsen scoliosis?
Scoliosis increases rapidly in severity during growth period of a child, which lasts up till age 17 years. So growing makes scoliosis worse. This is not always true but happens in most cases.
Here is an example of scoliosis getting worse with rapid growth. This child was seen 11 years of age with a 27 degree D6 to D12 curve. The child did not follow up and was seen again 13 months later without any treatment. The curve had rapidly increased to 44 degrees
Once growth is complete, the curvatures do not increase if the curve measures 30 degrees or less. For curves over 50 degrees, progression does happen even after growth is complete. Usually, the increase is 1 degree per year. This is not much, but if a curve is 70 degrees at 17 years of age, it has a potential to increase by another 50 degrees by the time the patient is 67 years of age.
Does scoliosis correct itself ?
Some scoliotic curves that are present in infancy can resolve on their own.
Then occasionally, a spinal curve may be seen but this may not be a true scoliosis. It may be secondary to other pathologies, such as a spinal tumour, a syrinx, a vertebral infection, or even a disc prolapse. In these cases, correcting the underlying pathology corrects the scoliosis
What gender is scoliosis most common?
Scoliosis is more common in females. The incidence of larger curves is higher in females. Scoliotic curves are eight times more likely to progress sufficiently such as to require treatment. However, the results of brace treatment in females of growing age are better than in males.
Can scoliosis be corrected? / How do I straighten my scoliosis spine?
Scoliosis treatment depends on the severity of the curve and age of the patient.
An adolescent who has reached the end of growth with a small spinal curve and a balanced posture does not need treatment or may need physical therapy for scoliosis.
A growing child who has a diagnosis of idiopathic scoliosis with a small curve not sufficient to necessitate treatment is kept on observation in our clinic till completion of growth.
A curve of 15 degrees in a child with significant growth remaining will need to be braced. We will also recommend scoliosis specific physiotherapy in our clinic.
A very young child with a rapidly progressive scoliosis will need cast treatment followed by bracing. Many such children need growing rods surgery if casting and bracing do not work. This is fusionless surgery and allows the spine to grow as the child grows while maintain correction.
Patients with large scoliotic curves are initially treated by bracing, scoliosis specific exercises and observation. Many of these patients undergo surgery towards end of growth to balance the trunk and correct the scoliotic deformity.
Is Scoliosis surgery a major operation?
Scoliosis treatment by surgery is a major operation.
What is the treatment for 30-degree scoliosis?
A 30-degree scoliosis curve typically requires bracing for younger patients or surgical evaluation if the curve is progressing.
Is scoliosis surgery successful ?
Scoliosis treatment by surgery is very safe. Scoliosis correction is a highly successful operation with a low complication rate.
When can I walk after scoliosis surgery
We encourage walking 72 hours following the surgery
When can I return to normal activity?
It takes 8 weeks after surgery to return to normal activity.
How can I fix scoliosis naturally?
Most abnormal curves are minor and may not progress to scoliosis treatment. However, observation is essential and once the curve increases, measures like brace treatment and exercises are started.
What is the best treatment for scoliosis?
The most effective treatment depends on the type of the curve and its magnitude and progress. Scoliosis treatment without surgery and preventive treatment following early detection is the best treatment. All efforts must be made to pick up scoliosis when mild,, and then treat it by bracing and Physical therapy for scoliosis to keep the curve to under 30 degrees. Early diagnosis by an alert clinician, early treatment with brace application and exercise program is important. There is good medical evidence for these methods. A child will lead a normal life if the scoliotic deformity remains less than 30 degrees.
Is scoliosis treatment in adults possible without surgery?
The scoliosis can be greatly improved by an effective exercise regime which is available through our clinic.
However, once the spine becomes arthritic and the spinal curves are large, surgery can provide the only effective solution.
Can Ayurveda cure scoliosis?
No – there is no medical evidence that Ayurveda can cure scoliosis.
What is the life expectancy of someone with scoliosis?
With proper treatment, scoliosis does not significantly impact life expectancy. However, untreated severe cases may lead to complications affecting lung or heart function.
Can you fix scoliosis?
Please see ‘Scoliosis treatment’ as above.