Karpushin A.A. - scoliosis treatment by child and adults

Displastic (idiopathic) scoliosis in children. Children scoliosis

1. Female patient, 12 years old.

Before the surgery: displacement of the pelvis, curvature of the chest, marked rib hump Click the picture to enlarge
Patient, 12 years old. Before the surgery Patient, 12 years old. Before the surgery Patient, 12 years old. Before the surgery

The surgery was performed according to our technique without damaging the spine. A growing titanium structure was implanted. Practically, a complete restoration of the anatomy of the chest and straightening of the spine was achieved. The patient stayed in the hospital for 5 days.

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Patient, 12 years old. After the surgery Patient, 12 years old. After the surgery
A year after the surgery elapsed, due to the elasticity and constant distraction, the further flattening of the chest and spine was achieved. The appearance improved too.
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1 year after surgery 1 year after surgery



2. Female patient, 13 years old. Kyphoscoliosis of Grade 4. The 128 degree curvature

Conservative treatment was conducted in a hospital of the patients residential area in a large regional centre using physical therapy, massage, corsets, manual therapy, and further on. The parents used traditional healers. The result was: a serious advanced deformity of the chest, and a life-threatening curvature of the spine. Psychological suppression of individuality had developed during the period of the disease.

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Female patient, 13 years old. Kyphoscoliosis of Grade 4. The 128 degree curvature Female patient, 13 years old. Kyphoscoliosis of Grade 4. The 128 degree curvature Female patient, 13 years old. Kyphoscoliosis of Grade 4. The 128 degree curvature

Surgery. No part of the spine was damaged and was not removed. Blood and plasma were not transfused as this was not necessary. Immediately after the surgery, the girl was transferred to a regular room under the surveillance of the duty personnel and her parents. After three days, she was set on her feet and, in five days after the surgery, she was released from the hospital.

The patients growth increased by 6 cm. A growing strained structure was implanted, which will continue to correct the remaining deformations for 2 years without additional and repeated operations. The structure will allow the girl to grow normally.
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Female patient, 13 years old. Kyphoscoliosis of Grade 4. The 128 degree curvature. 3 days after surgery Female patient, 13 years old. Kyphoscoliosis of Grade 4. The 128 degree curvature. 3 days after surgery Female patient, 13 years old. Kyphoscoliosis of Grade 4. The 128 degree curvature. 3 days after surgery

In three days after the surgery, the curvatures of the chest and the spine were eliminated, and the progression of the process was stopped. A severe scoliosis in this girl did not appear immediately. One can see how it had been developing. Here is the dynamics of the scoliosis development in the patients on radiographs:
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2006 year,  35 degrees
2006 year, 35 degrees
2007 year, 43 degrees
2007 year, 43 degrees
2008 year  50  degrees
2008 year 50 degrees
2009 year  61 degrees
2009 year 61 degrees
2010 year  92 degrees
2010 year 92 degrees
2011 year   103 degrees
2011 year 103 degrees
2013 year   128  degrees!
2013 year 128 degrees!
After the surgery: the residual arc measures 36 degrees
After the surgery: the residual arc measures 36 degrees

When examining the changes in the vertebrae and the ribs of this patient, it is observed that the first minor structural changes in 2006 gradually became more visible, and, by 2013, they became extremely severe. Irreversible changes in the structure and shape of the vertebrae can bee seen by taking, as an example, the eighth thoracic vertebra for the period of 7 years from 2006 to 2013.

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2006 year
2006 year
2013 year
2013 year

The changes influence the ribs, too, which can be in contact with each other in advanced cases. The deformation of the ribs is practically irreversible, too, even though the intercostal spaces do straighten out quite well due to the greater ability of distraction of soft tissues and the natural flexibility of the ribs. During the operation, the lungs were straightened, and the compression of the heart and the abdominal organs was eliminated.

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The ribs and vertebrae in 2006
The ribs and vertebrae in 2006
Those same ribs and vertebrae in 2013
Those same ribs and vertebrae in 2013

The surgery had to be performed back in 2006-2008, without waiting for off-limit irreversible changes. Attempts were made to treat the girl using conservative methods, but every year the curvature continued to progress steadily.
It is difficult to understand by what considerations the orthopaedists in this or another city had been motivated, acquiescently watching the tragedy of children, rather than directing them for surgery in time. This practice, unfortunately, is quite common in our country and it continues into the 21st century.

In case of the scoliosis progression, when the curvature reaches 25-30 degrees, the surgery should be performed regardless of age!

The indications for surgery for scoliosis are even minor structural changes in the vertebrae and ribs. Deformations in progressive scoliosis develop quite rapidly


3. Patient, 13 years old. Diagnosis: Progressive dysplastic scoliosis of Grade 4

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Patient, 13 years old. Diagnosis: Progressive dysplastic scoliosis of Grade 4 December 2012, 45 degree curvature
December 2012, 45 degree curvature
July 2013, 62 degree curvature
July 2013, 62 degree curvature

Within eight months, the angle of the curvature increased by 17 degrees. Anatomical changes also became more pronounced. The 7th, 8th and 9th thoracic vertebrae had acquired an irregular shape, the ribs and the spacing between them had changed. The rapid development of anatomical abnormalities could lead to serious distortions. A surgery was performed the correction of the curvature of by the growing strained structure. During the surgery, the spine was not hurt, nor were the connections between the vertebrae damaged.

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Patient, 13 years old. After surgery Patient, 13 years old. After surgery

In three days after the surgery, the ribs and vertebrae of the patient acquired a normal anatomical shape, as they preserved enough plastic potential.


4. Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees)

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Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees) Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees) Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees) Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees)

Three days after the surgeryClick the picture to enlarge
3 days after surgery 3 days after surgery 3 days after surgery

Within a year after the surgery, the patients condition improved significantly. The X-rays revealed that the residual curvature decreased substantially due to the elasticity of the structure.

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Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees). 1 year after surgery Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees). 1 year after surgery Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees). 1 year after surgery Female patient, 14 years old. Diagnosis: kyphoscoliosis of Grade 4 (50 degrees). 1 year after surgery



5. Female patient, 11 years old. Diagnosis: advanced scoliokyphosis of Grade 4 (136 degrees)

Scoliosis started to develop from the age of eight. The treatment in the medical institution in her residential district had proved ineffective. The patient had been consulted, including in Israel and Germany, where traumatic operations with the risk of neurological complications, or corsets had been proposed. It had been proposed to perform a surgical treatment only after the end of the growth. But it had not been possible to wait until the end of the growth as the girls scoliosis had been progressing rapidly and irreversibly.
At admission Click the picture to enlarge
Female patient, 11 years old. Diagnosis: advanced scoliokyphosis of Grade 4 (136 degrees) Female patient, 11 years old. Diagnosis: advanced scoliokyphosis of Grade 4 (136 degrees) Female patient, 11 years old. Diagnosis: advanced scoliokyphosis of Grade 4 (136 degrees)

In three days after the surgery, the patient experiences no pain and can walk without assistance. Her spine was not injured during the surgery. The growth increased by 6 cm. A growing titanium structure was implanted. Repeated surgeries are not planned, as the structure will lengthen as the child grows. Complications are non-existent.

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Female patient, 11 years old. Diagnosis: advanced scoliokyphosis of Grade 4 (136 degrees). 3 days after surgery Female patient, 11 years old. Diagnosis: advanced scoliokyphosis of Grade 4 (136 degrees). 3 days after surgery Female patient, 11 years old. Diagnosis: advanced scoliokyphosis of Grade 4 (136 degrees). 3 days after surgery