ESCOLIOSIS: CONSIDERACIONES PARA EL TRATAMIENTO

En un artículo anterior definíamos los momentos de detección y diagnóstico de la escoliosis y su relación con los distintos periodos de osificación de diferentes estructuras anatómicas a lo largo del crecimiento de la persona.

Relacionando estas dos ideas es posible sacar algunas conclusiones de cara al tratamiento que podemos realizar, definir las expectativas y el pronóstico.

Respecto al tratamiento cuanto más tarde atendamos al niño/a, el margen de maniobra es menor ya que la “holgura” que nos presentan las estructuras sobre las que trabajamos es menor.

Cuanto más avanzado el crecimiento y más “cerrados” los huesos más difícil será generar remodelación de las formas.  En última instancia deberemos trabajar con vistas a controlar la posible insuficiencia respiratoria y para mantener la escoliosis alineada limitando así su evolutividad.

Por otro lado, cuanto antes diagnosticamos la escoliosis tendremos más posibilidades terapéuticas pero más riesgo de evolución ya que pasaremos por más etapas de osificación.  Una escoliosis juvenil I de pocos grados nos genera más necesidad de atención que otra escoliosis pubertaria de más graduación,  ya que en el primer caso tendremos dos etapas pendientes de atravesar con el riesgo de agravamiento en esos periodos (siempre que no hablemos de angulaciones excesivamente severas en el periodo pubertario).

De modo que cuanto más joven es el niño más posibilidades hay de un verdadero cambio en las curvas aunque manejamos una espalda más difícil de mantener bajo control.  En cambio en niños más mayores tendremos que redirigir nuestras expectativas hacia el control de la evolutividad y el cuidado de las complicaciones respiratorias.

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