{"id":13472,"date":"2023-12-10T23:29:43","date_gmt":"2023-12-10T23:29:43","guid":{"rendered":"https:\/\/ro.cvot.md\/tratamentul-scoliozei-moderate-si-severe\/"},"modified":"2025-10-05T21:15:08","modified_gmt":"2025-10-05T21:15:08","slug":"tratamentul-scoliozei-moderate-si-severe","status":"publish","type":"page","link":"https:\/\/ro.cvot.md\/en\/coloana-vertebrala\/tratamentul-scoliozei-moderate-si-severe\/","title":{"rendered":"Treatment of Moderate and Severe Scoliosis"},"content":{"rendered":"\n<p><br><strong>Treatment of Adolescent Idiopathic (Dysplastic) Scoliosis in Patients with Completed Growth (Age >10), with Moderate (20-69\u00b0) and Severe (Up to 80-85\u00b0) Curvature<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=Q5WtOQwmyfU\" target=\"_blank\" rel=\"noreferrer noopener\">Watch the video on YouTube<\/a><\/p>\n\n\n\n<p><strong>Clinical Considerations<\/strong><\/p>\n\n\n\n<p>Adolescent idiopathic scoliosis (AIS) is characterized by abnormal curvature of the spine, and when it progresses to moderate (20-69\u00b0) or severe (up to 80-85\u00b0) stages, it leads to significant deformities not only in the spine but also in the rib cage and thoracic cavity. This results in functional disturbances in various body systems, including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Central Nervous System (CNS)<\/strong><\/li>\n\n\n\n<li><strong>Respiratory system<\/strong>: Compromised lung function due to restricted chest space.<\/li>\n\n\n\n<li><strong>Cardiovascular system<\/strong>: Altered blood circulation due to compression of the heart.<\/li>\n\n\n\n<li><strong>Digestive system<\/strong>: Possible digestive issues due to pressure on the abdominal organs.<\/li>\n\n\n\n<li><strong>Excretory system<\/strong>: Disruptions in kidney function and other organs.<\/li>\n\n\n\n<li><strong>Endocrine system<\/strong>: Hormonal imbalances related to the spinal deformity and systemic effects.<\/li>\n\n\n\n<li><strong>Musculoskeletal system<\/strong>: Muscle imbalance and atrophy, joint dysfunction.<\/li>\n<\/ul>\n\n\n\n<p>Thus, the progression of scoliosis leads to a complex pathological symptom complex, causing it to be recognized not just as a spinal deformity, but as a <strong>scoliotic disease<\/strong> that affects the entire body system (A. Radulescu 1961, I.A. Movshovich 1964, Ya.L. Tsivyian 1972, A.I. Kazmin 1980, M.G. Dudin 2005).<\/p>\n\n\n\n<p><strong>Current Treatment Approaches<\/strong><\/p>\n\n\n\n<p>For adolescents aged 14-16 years with <strong>completed growth<\/strong> and <strong>mobile spinal deformities<\/strong>, treating moderate (20-69\u00b0) and severe (up to 80-85\u00b0) scoliosis has become a relatively straightforward task for <strong>vertebrology<\/strong> specialists. With the use of modern surgical methods, a full correction can be achieved with high precision.<\/p>\n\n\n\n<p><strong>Optimal Correction Methods for Severe Mobile Scoliosis in Adolescents with Completed Growth<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Dorsal Spinal Release<\/strong>:\n<ul class=\"wp-block-list\">\n<li>A key technique to release tension in the spine and allow for better realignment of the vertebrae.<\/li>\n\n\n\n<li><strong>Tenoligamentocapsulotomy<\/strong> (according to Shulutko) is used to facilitate spinal correction by cutting and releasing the tension in spinal ligaments and joint capsules.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Total Facetectomy<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Removal of both the upper and lower facet joints to improve mobility and facilitate the alignment of the spine during the correction phase.<\/li>\n\n\n\n<li>This procedure is essential for mobile deformities to enable full reduction of the curvature.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Transpedicular Fixation and Posterior Autospinal Fusion<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Using <strong>transpedicular screw systems (CD system)<\/strong> for rigid fixation across the entire length of the deformed spinal segment.<\/li>\n\n\n\n<li><strong>Thoracoplasty<\/strong>: In some cases, corrective surgery for the rib cage may also be performed to improve chest wall shape and functionality.<\/li>\n\n\n\n<li>The combination of <strong>posterior fusion and screw fixation<\/strong> is considered the most effective method for correcting severe deformities and ensuring stability of the spine after surgery.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<p>These approaches allow for <strong>100% correction<\/strong> of the spinal deformity, achieving excellent long-term results.<\/p>\n\n\n\n<p><strong>Clinical Case Study<\/strong><\/p>\n\n\n\n<p>A <strong>clinical case<\/strong> of an adolescent with <strong>severe idiopathic scoliosis<\/strong> (moderate to severe curve of 70\u00b0-80\u00b0) was treated using the methods outlined above. The patient underwent:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Dorsal spinal release<\/strong> via tenoligamentocapsulotomy.<\/li>\n\n\n\n<li><strong>Total facetectomy<\/strong> (both upper and lower facet joints were removed).<\/li>\n\n\n\n<li><strong>Transpedicular fixation<\/strong> using a CD system, followed by <strong>posterior autospinal fusion<\/strong>.<\/li>\n<\/ul>\n\n\n\n<p>This approach resulted in a <strong>complete correction of the spinal deformity<\/strong> with a significant improvement in posture and function. The patient experienced not only aesthetic improvements but also a marked reduction in pain and better organ function (respiratory and cardiovascular systems) post-surgery.<\/p>\n\n\n\n<p><strong>Key Points:<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Advanced surgical techniques<\/strong> now allow for significant improvement in spinal deformities.<\/li>\n\n\n\n<li><strong>Full spinal control and stabilization<\/strong> can only be achieved through bilateral fixation (placing two transpedicular screws in each vertebra along the entire curve of the deformity).<\/li>\n\n\n\n<li><strong>Postoperative recovery<\/strong>: The patient regained full range of motion and was able to return to normal physical activities within a few months, with excellent cosmetic and functional outcomes.<\/li>\n<\/ol>\n\n\n\n<p>This treatment strategy is recommended for adolescents with severe scoliosis who have completed their growth and present with <strong>mobile spinal deformities<\/strong>. The goal is not only to correct the deformity but also to preserve or improve the function of internal organs and overall quality of life.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><img decoding=\"async\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/12\/scolios28.jpg\" alt=\"\"><\/td><td><img decoding=\"async\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/12\/scolios29.jpg\" alt=\"\"><\/td><\/tr><tr><td colspan=\"2\"><br><strong>Before surgery<\/strong>: Deformation &#8211; 78\u00b0<br><strong>After surgery<\/strong>: Deformation &#8211; 0\u00b0<br><strong>Deformation correction<\/strong>: 100%<\/td><\/tr><tr><td><img decoding=\"async\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/12\/scolios31.jpg\" alt=\"\"><\/td><td><img decoding=\"async\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2023\/12\/scolios30.jpg\" alt=\"\"><\/td><\/tr><tr><td colspan=\"2\"><br><strong>Before surgery<\/strong>: Deformation &#8211; 78\u00b0<br><strong>After surgery<\/strong>: Deformation &#8211; 0\u00b0<br><strong>Deformation correction<\/strong>: 100%<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_5746-min-scaled.jpg\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1707\" height=\"2560\" data-id=\"12612\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_5746-min-scaled.jpg\" alt=\"\" class=\"wp-image-12612\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_5746-min-scaled.jpg 1707w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_5746-min-200x300.jpg 200w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_5746-min-683x1024.jpg 683w, 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1074w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_6352-min-1432x2048.jpg 1432w\" sizes=\"(max-width: 1790px) 100vw, 1790px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-scaled.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"1707\" height=\"2560\" data-id=\"12611\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-scaled.jpg\" alt=\"\" class=\"wp-image-12611\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-scaled.jpg 1707w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-200x300.jpg 200w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-683x1024.jpg 683w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-768x1152.jpg 768w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-1024x1536.jpg 1024w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7613-min-1365x2048.jpg 1365w\" sizes=\"(max-width: 1707px) 100vw, 1707px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-scaled.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"1236\" height=\"2560\" data-id=\"12618\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-scaled.jpg\" alt=\"\" class=\"wp-image-12618\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-scaled.jpg 1236w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-145x300.jpg 145w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-495x1024.jpg 495w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-768x1590.jpg 768w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-742x1536.jpg 742w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7796-min-989x2048.jpg 989w\" sizes=\"(max-width: 1236px) 100vw, 1236px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-scaled.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"1707\" height=\"2560\" data-id=\"12617\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-scaled.jpg\" alt=\"\" class=\"wp-image-12617\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-scaled.jpg 1707w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-200x300.jpg 200w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-683x1024.jpg 683w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-768x1152.jpg 768w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-1024x1536.jpg 1024w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/sam_7760-min-1365x2048.jpg 1365w\" sizes=\"(max-width: 1707px) 100vw, 1707px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"1600\" height=\"1600\" data-id=\"12620\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min.jpg\" alt=\"\" class=\"wp-image-12620\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min.jpg 1600w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-300x300.jpg 300w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-1024x1024.jpg 1024w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-150x150.jpg 150w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-768x768.jpg 768w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-1536x1536.jpg 1536w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-80x80.jpg 80w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-88x88.jpg 88w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-21_10-51-37-605-min-120x120.jpg 120w\" sizes=\"(max-width: 1600px) 100vw, 1600px\" \/><\/a><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-25_11-14-02-536-min.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"1587\" height=\"1463\" data-id=\"12621\" src=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-25_11-14-02-536-min.jpg\" alt=\"\" class=\"wp-image-12621\" srcset=\"https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-25_11-14-02-536-min.jpg 1587w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-25_11-14-02-536-min-300x277.jpg 300w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-25_11-14-02-536-min-1024x944.jpg 1024w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-25_11-14-02-536-min-768x708.jpg 768w, https:\/\/ro.cvot.md\/wp-content\/uploads\/2024\/06\/izobrazhenie_viber_2023-03-25_11-14-02-536-min-1536x1416.jpg 1536w\" sizes=\"(max-width: 1587px) 100vw, 1587px\" \/><\/a><\/figure>\n<\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Treatment of Adolescent Idiopathic (Dysplastic) Scoliosis in Patients with Completed Growth (Age >10), with Moderate (20-69\u00b0) and Severe (Up to 80-85\u00b0) Curvature Watch the video on YouTube Clinical Considerations Adolescent idiopathic scoliosis (AIS) is characterized by abnormal curvature of the spine, and when it progresses to moderate (20-69\u00b0) or severe (up to 80-85\u00b0) stages, it [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":13473,"parent":13485,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-13472","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Treatment of Moderate and Severe Scoliosis - Asocia\u0163ia Ob\u015fteasc\u0103 &#039;&#039;HEALTHY SPINE&#039;&#039;<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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