Spinal deformity, or scoliosis, is a process of deformation of the spine, characterized by pathological bending of the spinal column with rotation of the vertebrae. Typically, the deformed section of the spine has one or two curves, resembling the English letters "C" or "S".
The doctors at Top Ihilov Clinic correct such spinal deformities using a full range of modern methods – from the use of the latest designs of derotating orthopedic corsets to surgeries for spinal fusion performed on robotic systems.
Treatment of Spinal Deformity in Israel – Methods Available at Top Ihilov
Typically, the cause of spinal deformity cannot be determined, so up to 80% of scoliosis cases are idiopathic – a term in medicine for diseases that arise without visible causes, seemingly on their own. In 20% of cases, primary disorders such as muscle spasms, cerebral palsy, genetic connective tissue diseases (e.g., Marfan syndrome), and certain types of tumours (neurofibromatosis) are the causes of scoliosis.
The choice of treatment method for spinal deformity depends on the degree of curvature and the location of the deformed section. Various methods of conservative therapy and surgery are used for treatment. Conservative methods include therapeutic exercises and wearing a corset, while surgical methods include various types of spinal fusion with anterior or posterior access. Both conservative and surgical methods are equally applicable to children and adults, with the only difference being that in childhood, when the skeleton continues to grow actively, surgical treatment of spinal deformity using fixation devices is undesirable and is used only in extreme cases when the deformation progresses rapidly and conservative methods do not yield the desired effect.
Conservative Methods of Treating Spinal Deformity
The conservative approach to correcting the spinal column allows for good results with a postural deviation of up to 45 degrees. If a patient has a mild degree of scoliosis and the angle of deviation does not exceed 20-30 degrees, posture can be corrected through physical exercises. A very effective therapeutic method in this case is the exercise program developed by German physician Katharina Schroth. The Schroth system includes a set of breathing, isometric, and exercises aimed at reverse rotation of the vertebrae, allowing for the development of a stereotype of physiologically correct spinal positioning. Exercises for each patient are selected individually.
For angles of postural deviation exceeding 20-25 degrees, treatment of scoliosis may require wearing a corrective corset. Orthopedic corsets come in various designs, made of metal or plastic, and provide correction of posture in the desired direction. Most commonly, our clinic uses Sheno corsets, Milwaukee corsets, and Boston corsets for scoliosis correction. They differ somewhat in their structural design. Boston corsets are made of plastic and are usually used for treating idiopathic scoliosis in children. Milwaukee corsets differ from Boston corsets by having metal reinforcements and are more frequently used for treating spinal deformity in adults. Sheno corsets combine the advantages of the first two types of orthopedic corsets and can be used for spinal correction in both children and adult patients.
The corset is usually required to be worn most of the day, and in some cases, it may be removed for only 1 hour for hygiene procedures and therapeutic exercises. Therefore, while the use of derotating corsets effectively corrects scoliosis, it is associated with certain psychosocial inconveniences and physical discomfort. However, there have been certain successes in this area – global orthopedics is not stagnant, and more advanced designs of derotating corsets are emerging. In addition to the corsets described above, our clinic uses several types of modern orthopedic braces – nighttime Charleston corsets, SpineCor corsets with elastic elements, plastic-aluminum SpoRT corsets, improved Sheno system corsets (dynamic asymmetric Crass-Sheno brace), etc.
Surgical Methods of Treating Scoliosis
Surgical methods for correcting spinal deformity are usually recommended for postural deviations greater than 40-50 degrees and involve performing spinal fusion – correcting deformed sections of the spinal column using metal or bone implants. Open surgery is performed with either posterior or anterior access – the incision is made along the midline of the back or along the side of the ribs, respectively.
To restore physiologically correct angles of the spine, special metal implants are used, which connect to each other and to the vertebrae with transverse bridges and screws. This approach is used when performing spinal fusion with posterior access.
Surgical correction of scoliosis with anterior access involves removing one or more intervertebral discs and filling the freed space with bone cement. The positioning of the vertebrae is also corrected using metal screws.
Patients at Top Ihilov Clinic also have access to a modern method of surgical treatment for scoliosis, such as minimally invasive surgeries using the Renaissance robot. The Renaissance system allows for spinal fusion to be performed with a much smaller incision compared to open surgery. Using the robotic system, the surgeon fixes the deformed section of the spine with metal fasteners and implants fragments of the patient's or donor's bone tissue into the space between the vertebrae. These implants can be solid bone grafts or sleeves (plastic, metal, made of carbon fiber) filled with bone cement. After some time following the surgery, the grafts or ground bone tissues that make up the bone cement fuse with the adjacent vertebrae and reliably immobilize them, achieving the desired correction of the spine. The Renaissance system allows for the operation to be guided by a computer model of the spine, thereby reducing the frequency of intraoperative X-rays, which ultimately minimizes the radiation exposure to the patient.
- Endoscopic correction of the spine
Diagnosis of Spinal Deformity at Top Ihilov
Examination of patients with scoliosis at our clinic takes no more than 3 days.
First Day – Visit to the Clinic
On the first day, the patient, upon arriving in Israel, meets at the airport with a case manager – a representative of the clinic who will act as a guide and translator, as well as coordinate the entire process of diagnosis and treatment. Together with the case manager, the patient goes to the hotel where they will stay, and then proceeds to the clinic for the first consultation with the leading specialist. The specialist reviews the medical history, conducts a primary examination, and prescribes a series of diagnostic procedures.
Second Day – Diagnosis
On the second day, all diagnostic procedures prescribed by the leading specialist are carried out. These may include various procedures.
- X-ray examination.
- Scoliometry (determination of the Cobb angle).
- Genetic testing. By analyzing the patient's DNA, doctors study several dozen genetic markers, the ratio of which allows conclusions to be drawn about either a high probability of further deformation or the stability of the spine.
Third Day – Selection of Method for Spinal Correction
On the third day, the leading specialist, along with a team of other doctors, analyzes the results of the diagnostics and selects the most effective method for correcting scoliosis.
- A new minimally invasive diagnostic method in Israel – thoracoscopy
Treatment of Spinal Deformity in Israel – Prices
The cost of treating spinal deformity in Israel is much lower than in other countries. Thus, scoliosis correction at our medical center allows for savings of up to 30-50% compared to similar treatment in hospitals in the European Union or the United States.
Advantages of Scoliosis Treatment at Top Ihilov Center
An important factor in assessing the effectiveness of spinal deformity treatment in Israel is the feedback from patients who have already received highly professional assistance in Israeli clinics. Patients who have undergone spinal correction at Top Ihilov Center mostly speak warmly and gratefully about both the clinic itself and its doctors. Top Ihilov is a center that is one of the leading medical institutions in Israel; our clinic has several important advantages compared to other Israeli hospitals.
- Spinal surgeons and orthopedists working at Top Ihilov have immense experience in treating spinal diseases and correcting deformities. Orthopedics is one of the most developed fields of Israeli medicine, and research by Israeli specialists largely determines the paths of development in global orthopedics. Therefore, by receiving treatment at Top Ihilov, you can be confident that you have entrusted your health to the best of the best.
- Top Ihilov Clinic uses only the most modern equipment, which allows our specialists to accurately localize spinal deformities, determine their parameters, and provide effective treatment. The robotic systems used at Top Ihilov for performing spinal fusion elevate surgical treatment of scoliosis to a fundamentally new level and significantly shorten the postoperative rehabilitation period for patients.
- Every patient with scoliosis who comes for treatment at Top Ihilov Medical Center receives a personalized therapy program. Individual attention to the patient, ensuring comfortable living conditions, and full support from a case manager-translator are just a few of the principles on which our center's work is based.