IDIOPATHIC SCOLIOSIS

Idiopathic scoliosis is a spinal deformity characterized by a sideways curvature of the spine that typically begins after the age of 9. While the exact cause remains unknown, genetic factors play a significant role, often running in families and affecting girls and young women more frequently and severely than boys and young men.

The diagnosis of idiopathic scoliosis involves a comprehensive evaluation, including a family history assessment and a physical examination. During the examination, various tests, such as the Adam’s forward bend test, are performed to assess spinal alignment and symmetry. Imaging tests such as X-rays and MRI scans help determine the severity of the spinal curve, measured in degrees, and aid in treatment planning.

Non-Surgical Treatments:

• External Bracing:
  Bracing is commonly used to prevent mild to moderate cases of scoliosis from progressing, particularly in young patients with significant growth remaining. Different types of braces, such as the Wood Chenau brace associated with the SCHROTH method or the Providence Brace, may be recommended based on individual needs and preferences.
• Exercise/Physical Therapy:
  Physical therapy regimens like the SCHROTH method, taught by specialty-trained therapists, are effective in maintaining core strength and increasing comfort. These exercises help individuals with scoliosis strengthen their core muscles, which is vital for spinal support and stability.

Surgical Treatments:

• Spinal Fusion:
  Spinal fusion is the most common surgical procedure for severe cases of scoliosis, where rods and screws are used to fuse vertebrae, straightening the spine. This procedure is typically considered when all other treatment methods have failed.
• Fusionless Surgery:
  Techniques such as VEPTR and growing rods like MAGEC are utilized for very young patients with progressive scoliosis to straighten the spine without fusion, allowing for continued growth and development.
• Vertebral Body Tethering:
  This surgery, performed anteriorly without fusion, is used in patients with moderate curves who have growth remaining. Flexible bands are used to connect screws in the vertebral body, avoiding the need for fusion.
• Thoracoplasty:
  A cosmetic procedure involving the removal of protruding ribs, sometimes combined with other surgical procedures, to improve spinal alignment and appearance.

At the Paley European Institute, we offer a multidisciplinary approach to idiopathic scoliosis treatment, integrating physical therapy, bracing, and surgical interventions when necessary. Our team of experts is dedicated to providing personalized care tailored to each patient’s unique needs, ensuring optimal outcomes and enhancing the overall well-being of individuals living with idiopathic scoliosis. Through our expertise, innovation, and compassionate approach, we strive to support our patients on their journey to spinal health and improved quality of life.

CONGENITAL SCOLIOSIS

Congenital scoliosis is a condition characterized by a sideways curvature of the spine that occurs at birth and is associated with abnormal spinal architecture. While the exact cause remains unknown, genetic factors play a significant role, as the condition often runs in families.

In some cases of congenital scoliosis, the spine may develop with an unsegmented bar on one side and a hemivertebra on the other, leading to an increased curvature of the spine. This combination contributes to the abnormal spinal architecture observed in congenital scoliosis cases.

A spine affected by congenital scoliosis may develop compensatory curves in the opposite direction above or below the affected area. These additional curves serve to balance out the primary scoliosis curve, helping to maintain overall spinal alignment.

During spinal development, the spine initially forms as a single tissue that later divides into segments, which ultimately develop into individual vertebrae. However, if these segments fail to separate properly, it can result in partial or complete fusion of two or more vertebrae. The presence of an unsegmented bar prevents the spine from growing straight, leading to the development of a spinal curve characteristic of congenital scoliosis.

Treatment for congenital scoliosis is tailored to each individual’s specific needs and may involve observation, bracing, or surgical intervention, depending on the severity and progression of the curvature. Our multidisciplinary team at the Paley European Institute is dedicated to providing personalized care and comprehensive treatment options to optimize spinal health and improve quality of life for individuals with congenital scoliosis. Through our expertise, innovation, and compassionate approach, we strive to achieve optimal outcomes and support our patients on their journey to spinal health and well-being.

HEMIVERTEBRA

Hemivertebra is a rare congenital spinal deformity characterized by the improper development of a section of a vertebra, resulting in a wedge shape. This condition can lead to spinal imbalance and the development of curves such as scoliosis or kyphosis. At the Paley European Institute, we offer specialized treatment options to address the complexities of hemivertebra, aiming to restore spinal alignment and improve overall function for our patients.

Hemivertebra occurs during fetal development due to the improper formation of a vertebra, although the exact cause remains unknown. The severity of hemivertebra depends on its impact on spinal alignment and its attachment to adjacent vertebrae.

Diagnosing hemivertebra involves a thorough evaluation, typically beginning with X-rays to identify the location and number of affected vertebrae. Additional imaging such as CT scans may be necessary to obtain clearer images of the condition, while MRI scans help rule out associated deformities.

Our approach to hemivertebra treatment is tailored to the individual needs of each patient. Mild and non-progressive curves may be observed over time without surgical intervention. However, bracing has proven ineffective in managing hemivertebra.

For cases requiring surgical intervention, our skilled surgeons perform precise procedures aimed at addressing the underlying deformity. Surgical treatment involves the removal of the deformed vertebra, followed by fusion of the adjacent vertebrae to restore spinal stability. This procedure can be performed on children ranging from infants to adolescents under general anesthesia. Post-surgery, patients may require the use of a brace to support the spine during the healing process.

At Paley European Institute, we prioritize personalized care and patient-centered treatment plans for hemivertebra. Our multidisciplinary team collaborates closely to ensure that each individual receives comprehensive, compassionate care tailored to their specific needs and goals. Through our expertise, innovation, and dedication, we strive to achieve optimal outcomes and enhance the overall well-being of our patients living with hemivertebra.

SPONDYLOLISTHESIS

Spondylolisthesis, a condition characterized by the displacement of a vertebra, typically the 5th lumbar vertebra, onto the vertebra below, presents complex challenges that demand specialized care and individualized treatment strategies. At the Paley European Institute, we offer comprehensive approaches to managing spondylolisthesis, focusing on alleviating symptoms, restoring spinal stability, and improving quality of life for our patients.

Spondylolisthesis manifests as pain in the lower back, buttocks, and legs, often accompanied by sensations such as numbness, tingling, or weakness in the lower extremities. This condition arises from the misalignment and narrowing of the spinal column, exerting pressure on spinal nerves and resulting in discomfort and impaired mobility.

Spondylolisthesis can be congenital or develop later in life, often as a result of genetic predisposition, physical overuse, or trauma. Our diagnostic approach begins with a comprehensive assessment, including X-rays to evaluate spinal alignment and vertebral position. Further imaging such as CT and MRI scans provide detailed insights into the severity of the condition, guiding our treatment planning process.

At Paley European Institute, we offer a range of treatment options tailored to each patient’s unique needs and preferences. Conservative approaches may include rest, activity modifications, physiotherapy for range of motion and core strengthening, anti-inflammatory medications, epidural injections, and bracing. These interventions aim to alleviate symptoms and improve spinal function without surgical intervention.

In cases of severe spondylolisthesis where conservative measures are insufficient, surgical intervention may be necessary. Our skilled surgeons specialize in advanced procedures such as decompressive laminectomy, which involves removing the portion of the vertebra and tissue compressing the nerves. To address spinal instability resulting from this procedure, spinal fusion is performed to stabilize the adjacent vertebrae and restore proper alignment.

At Paley European Institute, we prioritize personalized care and patient-centered treatment plans. Our multidisciplinary team collaborates closely to ensure that each individual receives comprehensive, compassionate care tailored to their specific needs and goals. Through our expertise, innovation, and dedication, we strive to achieve optimal outcomes and enhance the overall well-being of our patients living with spondylolisthesis.

KYPHOSIS

Kyphosis, characterized by an abnormal forward curvature of the spine leading to a rounding of the upper back or a hunchback, is a condition that demands specialized care and tailored interventions. At the Paley European Institute, we offer comprehensive treatment options to address the diverse needs of individuals affected by kyphosis, ranging from conservative approaches to advanced surgical correction.

Kyphosis primarily affects the thoracic area of the spine, although it can involve the cervical and lumbar sections as well. Symptoms vary in severity, from minor changes in back appearance to more pronounced nerve problems and chronic back pain. The spinal curve can exert pressure on the spinal cord and nerves, leading to weakness in the legs and, in severe cases, breathing difficulties due to lung compression. Kyphosis may result from various factors including metabolic issues, neuromuscular conditions, spinal abnormalities like spina bifida, osteoporotic fractures, traumatic injuries, or disc slippage.

Our diagnostic process begins with a thorough examination of the patient’s medical history and symptoms, followed by a physical examination to assess spine movement, muscle strength, and sensation. Additional imaging tests such as X-rays, MRI scans, and CT scans help us accurately evaluate the structure of the spine and measure the degree of curvature.

At Paley European Institute, we emphasize a multidisciplinary approach to kyphosis treatment. Conservative methods, including medications, exercises, casting, and bracing, are often the initial course of action. Physical therapy and rehabilitation programs aim to enhance strength and mobility, offering relief from pain and improving overall spinal health. For cases related to osteoporosis, our focus is on slowing disease progression through targeted interventions such as vitamin supplementation, hormone replacement therapy, and exercise regimens.

Surgery becomes necessary in severe or refractory cases of kyphosis, where the potential benefits outweigh the risks. Our skilled surgeons specialize in advanced spinal procedures aimed at correcting spinal deformities and restoring spinal alignment. Surgical techniques may involve vertebral fusion to create a stable, straight spine, thereby reducing the curvature and alleviating associated symptoms.

At Paley European Institute, we recognize that each patient with kyphosis presents unique challenges and requires individualized care. Our team of experts is dedicated to delivering compassionate, personalized treatment plans tailored to the specific needs and goals of each individual. Through our commitment to innovation, expertise, and patient-centered care, we strive to achieve optimal outcomes and enhance the quality of life for individuals living with kyphosis.

SPINA BIFIDA

At the Paley European Institute, we understand the complexities of treating spina bifida and are dedicated to providing comprehensive care tailored to each individual’s needs. Our approach encompasses a range of interventions aimed at addressing the specific challenges associated with this condition, from neurological deficits to musculoskeletal abnormalities.

For children with spina bifida occulta, where there are no visible signs of the condition but underlying spinal abnormalities may exist, we offer thorough diagnostic evaluations to identify any potential health concerns. Our multidisciplinary team may recommend conservative management strategies such as physical therapy and ongoing monitoring to optimize long-term outcomes.

In cases of meningocele, characterized by the presence of a fluid-filled sac on the spine, our experts employ advanced imaging techniques to assess the extent of the spinal cord involvement. Treatment may involve surgical intervention to repair the spinal defect and prevent complications such as neurological deficits and infection.

For individuals with myelomeningocele, the most severe form of spina bifida, our team provides comprehensive care to address the complex array of symptoms and challenges. Surgical repair of the spinal opening is often a critical component of treatment, aimed at protecting the exposed spinal cord and minimizing the risk of further neurological damage. Additionally, we offer specialized interventions such as ventriculoperitoneal shunting to manage hydrocephalus and promote optimal neurological function.

Throughout the treatment process, our team emphasizes the importance of early intervention and ongoing support to maximize functional outcomes and enhance quality of life. Physical therapy plays a key role in promoting mobility, muscle strength, and independence, while our specialists guide bowel and bladder management techniques to improve daily functioning.

At the Paley European Institute, we recognize that each individual with spina bifida presents unique challenges and requires personalized care. Through our integrated approach, advanced surgical techniques, and compassionate support, we strive to empower our patients to thrive despite the complexities of this condition.