Spondylolysis- Spondylolisthesis

Treating Methods
1.Conservative Monitoring –Guardian
2.Surgically using Minimally Invasive Systems AP-Fix
3.Extensive spinal fusion using implants.

Scoliosis is the greater than 11° vertebral (column) curvature with simultaneous rotation of the vertebrae. Scoliosis is with simple words the excessive lateral curvature of vertebral column named.

Types of scoliosis

Vertebral column can be curved to every side of the body:

  • Curvature in chest region is known as thoracic scoliosis.
  • Curvature in the lowest point of the back is known as lumbar scoliosis.
  • Curvature between thoracic and lumbar spine is known as thoracolumbar scoliosis.
  • Curvature in thoracic and lumbar spine is known as double maximum curvature.

Scoliosis etiology

There are 4 main causes of scoliosis in children and young people:

  • Idiopathic – where causes are unknown.
  • Syndromic – where curvature constitutes part of a symptom of another disease.
  • Neuromuscular – where cause is associated with a neuromuscular disease which affects nerves and muscles.
  • Congenital – where spinal column is during infant development in uterus abnormally formed.

Scoliosis may rapidly or slowly develop, depending on each case.

Idiopathic scoliosis is the most frequent type, found in percentage 70-80% of all patients suffering from scoliosis. The cause is until today unknown.

Idiopathic scoliosis is divided into three types depending on age of disease appearance:

  • Infant scoliosis: From birth until 3 years.
  • Juvenile scoliosis: From 3 to 9 years.
  • Adolescent scoliosis: From 9 up to 18 years.

Last type constitutes 80% of all cases of idiopathic scoliosis.

The risk of idiopathic scoliosis progression is increased in adolescence, mainly in the phase of maximum growth. This phase begins in girls in the age of 11 and in boys in the age of 13, lasting in both sexes until 18.

It is in contrast particularly important that juvenile scoliosis is as soon as possible diagnosed. In case of juvenile scoliosis there is superiority in the appearance of the female sex in a 5/4 ratio whereas deformation type tends to be right thoracic or double maximum deformity. A percentage of 70% of the deformities futures aggravation and this is the reason why treatment by using splint or by conducting surgery is required. It is in all this cases necessary to conduct Magnetic Resonance Imaging (MRI).

The opinion of many experts and non in medical field that causes such as transport of heavy items like school bag in one shoulder, bad posture, sports and diet poor in calcium are not accepted by special spine surgeons. Furthermore none of the causes above has by large studies been proved.

Scoliosis treatment

Scoliosis treatment can be conducted either by conservative treatment and use of suitable splints or surgically depending on age, type and severity of the curvature, basic diagnosis and lung functionality of the patient.


The scoliosis splint delays curvature progression and can contribute to balance and function of patient posture. Nevertheless, its use is necessary needing parallely coordination of patient but also of his closer family environment. It is typical that it can be used from the age of nine months and maybe earlier for some severe curvatures in neuromuscular diseases. Splint is necessary also to be, in order to be more effective, 16-23 hours in a day applied.


The surgery is in patients with curvature greater than 40º and continued progression recommended. It is also recommended in cases with curvature greater than 50º, which leads to functionality disorders for the patient.

The main objectives of the intervention are:

  • To straight as much as possible spinal column.
  • To contribute to correction maintain so that curvature does not progress in adultness.

This is accomplished with:

  • Bridging the vertebrae across curvature and supporting the bridging bones with special tools- screws and metallic rods in spinal column.

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Dr. Stylianos N. Kapetanakis

Orthopedic and Spine Surgeon MD, FRCS, PhD
Priv. Consultant Spine Surgeon
Ass. Professor at Medical School of Democritus University of Thrace

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