The list of products is seemingly endless, extending from simple braces to complex spinal fixation systems. All the major orthopaedic companies are in the spinal space and the specialty is a hotbed of innovation and development. We’ll try to keep you up to date with the latest ideas and thinking, right here.
Starting with braces, otherwise known as orthoses. A nice source of information on braces can be found on spine-health.com here, where you will see images of the commoner brace types, the Boston Brace (or Thoraco-Lumbo-Sacral brace) and the Milwaukee Brace, which includes a cervical component and as such extends further up the body. Braces are typically intended to be worn for most of the time, under the clothing, and are intended primarily to prevent progression of the curvature during the spine’s development. What’s important to note is that recent clinical studies have shown bracing to be effective in around 50% of wearers, which is good news (they work) and bad news (but not on everyone). And unfortunately physicians are so far unable to predict who will benefit and who won’t.
Surgery is an option for progressive idiopathic scoliosis, that which has been unresponsive to bracing , or is severe enough that it would be disabling without intervention. Here again the list of products is vast, extending from the traditional metal rods to ever more sophisticated dynamic fixation devices with inbuilt adjustability and other features. Where braces do not correct curvatures, surgery can, albeit only to a limited extent.
All surgical approaches use variations on the theme in which hooks and screws are applied to the spine to anchor long rods, the most famous if which is the original Harrington Rod. The rods reduce the curvature and hold the spine rigidly in place while bone, grafted into the site during the procedure, will ultimately fuses together with existing bone. So while the rods are effectively a temporary splint while the bone fuses together, they are rarely removed as this is another major surgical intervention.
Many of the orthopaedic companies that have developed or sell spinal fixation systems will also carry bone grafts or so-called bone substitutes in their ranges. You may hear the words allograft and autograft, which are used to describe normal bone that has come from either another person or another par of the patient, such as the hip. Other materials used include bone substitutes, based on compounds that are known to encourage bony in-growth and as such behave as scaffolds which will infill with normal bone.
To learn more about the latest treatments and techonology in scoliosis surgery you can read in the articles in our technology section.