FAQ

Scoliosis is a three-dimensional alteration of spinal alignment. Unlike lordosis and kyphosis, which are normal conditions in individuals, scoliosis is considered a disease. The main curve in scoliosis occurs in the coronal plane, meaning that when we look at someone from behind, we notice a curvature of the spine, either in the thoracic or lumbar region. Its most common form is adolescent idiopathic scoliosis, which mostly affects girls between 10 and 14 years old, but can also be found in boys. Likewise, scoliosis is frequently found in mild forms that require nothing more than medical observation. Few cases will require external support from a brace, and those that will need surgical treatment represent the minority. Many cases of scoliosis are noticed by parents, relatives, or friends in situations where the child is shirtless, at the beach, or at the pool. Some are detected during school screening programs for the condition. In any of these situations, seek an evaluation from an orthopedist or pediatrician. If necessary, they will refer the patient to a spine specialist, who will determine the correct treatment. Evaluation by a spine specialist is important because some scoliosis cases do not follow the usual pattern and may originate from neurological diseases or congenital changes in spinal formation. These cases require special attention because they may be more aggressive and progress more rapidly. Scoliosis can be treated with excellent results, but diagnosis must be made early and treatment must begin immediately. Always seek a spine specialist for proper diagnostic evaluation and treatment planning.

Although it was developed several decades ago, video-assisted surgery for spinal conditions has become more popular in recent years thanks to technological advances, with cameras becoming increasingly smaller and more precise. In Brazil, it is already a reality and is available for patients with conditions such as lumbar and cervical disc herniation, as well as spinal canal stenosis. It may also be used for other spinal problems, although less frequently. Video-assisted disc herniation surgery is performed using a specific endoscope designed for the spine. It is a minimally invasive technique in which the herniated disc is removed through an incision smaller than 1 cm, with the help of a camera and special instruments. The procedure is performed in a hospital, under general anesthesia or sedation. Blood loss is minimal, and the patient can usually stand up shortly after returning to the room. In most cases, the patient is discharged on the same day and quickly returns to usual activities. Pain radiating to the legs often improves immediately, and the pain from the procedure itself is much lower than with the conventional technique. The major advantage of this approach is that it preserves the spinal muscles, with minimal tissue aggression, allowing faster recovery. Just as arthroscopy replaced open surgeries in other areas, video-assisted surgery has been gaining ground in spine care and is an excellent option when properly indicated. To find out whether your case is suitable, seek a spine specialist with experience in video-assisted surgery.

One of the most frequent questions patients ask spine specialists is exactly this: What is the best mattress for my back? It is essential for this question to exist, since we spend about one third of our lives in bed, and yet many people overlook the effect this has on their spine. Sleeping on a poor mattress can lead to an unbalanced posture, resulting in increased lower back pain and sleep deprivation. This may not only cause low back pain, but also affect the individual's overall health. Many patients ask whether a particular mattress brand is superior or better for spinal health. Although advertisements may lead you to believe so, there are no solid updated studies documenting which mattress brand improves sleep quality and reduces spinal problems. There are, however, some tips and guidelines you can follow to make your choice easier. In some aspects, choosing a mattress depends on individual preference, but it is important to find a balance between comfort and proper back support. The mattress should be firm enough to prevent you from sinking, but also soft enough to adapt to the body’s normal curves. The goal is to find a mattress that keeps the spine in a balanced position. Mattresses that are too firm may create pressure on more prominent points of the body, while mattresses that are too soft place stress on soft tissues such as muscles and ligaments, leading to poor alignment. A mattress with both support and comfort will allow your back to rest during sleep. Try to learn about the types of mattresses and their components yourself. Do not hesitate to ask questions. Support or firmness in a mattress is usually provided by inner springs, distributed in different patterns to create different levels of support. The internal padding and the top layer of the mattress also influence comfort. Evaluate whether your current mattress needs to be replaced. Visible sagging is a strong indicator. Flip and rotate your mattress every 4–6 months to ensure even wear. High prices do not always mean better quality or better results. Even though more robust mattresses tend to be more expensive, this does not guarantee real benefit. Always prioritize support and posture. Do not be influenced by advertisements. There is no solid medical evidence proving the superiority of brands or “orthopedic” models. If possible, try it before buying. If the mattress is for two people, both should test it together. Pay attention to your pillow as well. It should support the neck and maintain alignment with the body. Using more than one pillow can cause misalignment and pain. Ensuring a good night's sleep is essential not only for the spine, but for the body as a whole. Adjusting your mattress may be one of the most important decisions to improve your quality of life.

Resting and sleeping give the body a chance to recover from the postural, physical, and nervous strain of the day. Using some of the following pillows may improve the quality of your rest and recovery, allowing you to wake up feeling better and ready to face a new day. It is important to note that not every pillow works for everyone. A brief one-week test is usually enough to decide whether the pillow is beneficial or not. Knee pillow It is recommended to use a pillow between the knees for side sleepers, or under the thighs/knees for those who sleep on their backs, to relieve strain or overload on the lumbar spine. For side sleepers When someone sleeps on their side, bending the knees and placing a pillow between them prevents the knees from touching and keeps the spine in a neutral position. When there is no support between the legs, the upper leg rotates downward, pulling the pelvis and distorting the natural line of the spine. Adding support between the knees can prevent lower back pain induced by these types of forces, providing back relief and rest while sleeping. In general, a firm pillow between the knees works better than a soft one because it acts as a barrier to prevent the upper leg from rotating over the lower leg. For back sleepers When sleeping on the back, placing a pillow under the knee/thigh reduces the overload and weight placed on the lumbar spine. Some people even prefer placing two pillows to raise their knees even more. With two or more pillows under the knees, the lumbar spine straightens, reducing overload on painful facet joints of the spine. This position is the best for helping the back rest, and many people find that it is the only way to sleep during a severe episode of low back pain or while recovering from spine surgery. Body pillows Pillows as long as the body have several functions for people who prefer sleeping on their side, since the upper portion can be used to support the head and neck, while the lower end supports the knees and legs. Some people find this more comfortable than using separate pillows for the head and knees. Pregnant women, in particular, often prefer a body pillow because it provides additional support for the abdomen. Contoured neck pillow A pillow shaped to fill the spaces beneath the head and neck may be beneficial for people with cervical spine problems. Also called a cervical pillow or orthopedic pillow, this type of pillow has a deeper depression where the head rests and extra support for the neck. People with neck pain may use this pillow because it fills the empty space created by the neck and helps keep the neck aligned with the spine. Some orthopedic pillows may wear out after one to two years and may need to be replaced. Travel pillow U-shaped pillows, curved to fit around the neck, may be used for sleeping or supporting the head while seated. This type of pillow prevents the head from leaning too far to one side. It also creates support so that the weight of the head is distributed on the pillow. Lumbar support pillow A lumbar support pillow helps support the curve formed by the lordosis of the lumbar spine. Sitting for long periods without any support can cause muscle tension and lower back pain or sciatica. Used while seated, this pillow fills the natural space between the chair and the lumbar spine. Donut pillow or cushion This is an O-shaped cushion placed on the seat area of a chair. It has a depression in the center, reducing pressure on the coccyx region. People who have suffered a fracture or pain in the coccyx may benefit from this type of support.

We rarely think about our spine when we lie down to sleep, but posture during this period can be decisive for spinal well-being — and for preventing back pain. When lying down, it is important to follow some guidelines: Keep your spine in a neutral position You can do this by replacing an innerspring mattress with a foam mattress, adjusting your sleeping posture, or using appropriate pillows. Spring mattresses can create pressure points that do not properly support the natural curvature of the spine. Sleep on your back or on your side These positions place less pressure on the spine than sleeping on your stomach. This happens because body weight is distributed more evenly, reducing pressure points and maintaining proper alignment. Alternate sides if you sleep on your side Always sleeping on the same side can create muscle imbalance. Alternating sides and using a pillow between the knees helps keep the hips, pelvis, and spine aligned. Use a pillow correctly Regardless of position, the pillow should be between the head and neck, never under the shoulders. - On your back: use a lower pillow - On your side: use a higher pillow to compensate for shoulder width Your body shape matters If your hips are wider than your waist, a softer mattress may help keep the spine neutral. Bodies with a straighter alignment may benefit from firmer surfaces. Small sleep adjustments can directly impact the health of your spine and your quality of life.

What you need to know about low back pain Low back pain is not a disease, but a symptom that affects about 80% of the adult population at some point in life. It is the leading cause of absence from work and can even affect children. It is characterized by acute or chronic pain in the lumbar region, located in the lowest part of the spine, near the waist. Diagnosis Diagnosis is made clinically, based on symptoms and physical examination. Tests such as X-rays, CT scans, and MRI scans may be used to identify the cause. What are the causes? The main causes include: • Mechanical and postural causes — poor posture, obesity, pregnancy, and repetitive strain • Herniated disc — rupture of the intervertebral disc, usually caused by overload • Degenerative causes (osteoarthritis) — natural wear with aging, affecting joints, ligaments, and bone structures Treatment Most cases are treated conservatively, with relative rest, physical therapy, and pain medication. In the long term, the following are recommended: • Weight control • Regular physical activity • Stretching and strengthening exercises Surgical treatment is indicated only in a small portion of cases, when there is no response to conventional treatment.

This is a frequent complaint in orthopedic offices, especially among spine specialists. Patients often arrive worried after receiving these three diagnoses prematurely. The good news is that at least two of them are not problems. Lordosis and kyphosis are natural spinal curves and are present in all human beings. When we observe the body from the side, it is normal to have: • Cervical lordosis • Thoracic kyphosis • Lumbar lordosis These curves are physiological and essential for balance and walking. Some people may have variations, and this may still be within normal limits. Only when these curves are very pronounced are they considered alterations, such as hyperkyphosis or hyperlordosis. Scoliosis is different. Scoliosis represents a real alteration in spinal alignment. It may be noticed when observing a person from behind, with signs such as: • Spinal misalignment • Tilted shoulders or hips • Presence of a "rib hump" or back asymmetry Correct diagnosis depends on specialized medical evaluation and imaging tests. In most cases, the curvature is mild, less than 10 degrees, and does not represent significant scoliosis. Even when it exceeds this value, most cases do not require intervention. The most important thing is to undergo an evaluation with a spine specialist to obtain an accurate diagnosis and define the best course of action.

The spine is the central support axis of the body. Its 24 vertebrae make this structure highly mobile, while also protecting the spinal cord and nerve roots. At some point in life, about 80% of people will experience low back pain or back pain. Most cases are related to: • Poor posture • Inadequate biomechanics • A stressful routine • Loss of strength and flexibility • Low physical conditioning These factors can cause muscle strains, which usually improve within a few weeks with: • Medication • Heat or ice packs • Exercise • Physical therapy Prevention Prevention involves consistent lifestyle changes: • Postural correction • Proper use of mattresses and pillows • Regular physical activity • Balanced diet • Stress control • Sleep quality • Avoiding smoking When pain persists for more than 3 months, it may become chronic and indicate more serious problems, such as: • Herniated disc • Spinal stenosis • Degenerative diseases In these cases, evaluation by a spine specialist is essential. Treatment may range from conservative approaches to surgery, depending on the cause. The good news is that spine surgery has evolved greatly in recent decades, becoming less invasive, safer, and allowing faster recovery, with an earlier return to daily activities.

Orthopedic spine surgeons and neurosurgeons are equally qualified to perform most spine surgeries. Both work on the cervical, thoracic, and lumbar regions, performing procedures such as: • Decompression of the spinal cord and nerves • Spinal fusion • Microsurgery • Minimally invasive surgery Difference in training Both complete 6 years of medical school, but follow different paths in specialization: • Orthopedists They complete about 3 years of residency in the musculoskeletal system, including bones, joints, muscles, and nerves, and then another 2 years focused exclusively on the spine. • Neurosurgeons They complete a residency of approximately 5 years focused on the brain and spine, including the central nervous system. After that, both may pursue subspecializations in areas such as: • Minimally invasive surgery • Deformities, such as scoliosis • Spinal tumors • Pediatric spine • Complex reconstructions These training paths follow criteria established by organizations such as the Brazilian Spine Society (SBC). Is there a difference in practice? In some specific cases: • Orthopedists tend to have more experience with spinal deformities • Neurosurgeons may have more experience with tumors and diseases of the nervous system But, in general, both are fully qualified. How to choose the ideal specialist? More important than the specialty itself is practical experience in spine care. Important questions: • Do they have specific training in spine surgery? • Do they work in a specialized center? • Do they hold certification from the Brazilian Spine Society? • Do they work with minimally invasive techniques? • Do they mainly work with spine cases? After the appointment, also evaluate: • Was the diagnosis clearly explained? • Did you feel safe and comfortable? • Were treatment options presented besides surgery? In most cases, there are conservative alternatives before surgery, and a good specialist will always consider them.

Thousands of students go to school every day carrying backpacks on their shoulders, and about half of them carry more weight than recommended — which can cause overload, stress, and back pain over time. About 40% of spine specialists have treated children and adolescents with pain caused by improper backpack use or excessive weight. Problems range from muscle strains to conditions such as spondylolysis, a stress fracture of a vertebra. How to prevent injuries: Say yes to wheels Rolling backpacks are recommended for children who already experience pain or need to carry more than 10 kg. Traditional model Prefer backpacks with two padded straps and, if possible, lumbar support. Comfort is essential The backpack should fit the child's body well, with adjustable and comfortable straps. Avoid overload Excess weight is the main cause of problems. The backpack size should be proportional to the child's body. Ideal weight The backpack should not exceed 10% to 15% of body weight. Correct adjustment Always use both straps, properly adjusted to the shoulders. Internal organization Heavier items should be placed close to the back. Distribute weight evenly. Respect limits Avoid carrying excessive weight and encourage breaks when necessary. When used correctly, backpacks are safe and practical. However, if the child reports back or neck pain, it is important to seek specialist evaluation.

Half of pregnant women will experience some degree of back pain during pregnancy. This occurs mainly due to two factors: weight gain and the forward shift of the body's center of gravity, which overloads the muscles of the lumbar spine. How to minimize discomfort: Physical exercise Maintain an exercise routine, always with medical guidance. Lumbar and abdominal strengthening help significantly, and swimming is an excellent option to reduce impact on the back. Lifting weight When picking up objects from the floor, kneel with one knee and lift using your legs, not your spine. Keep the object close to your body and, whenever possible, ask for help. Carrying weight Prefer dividing the weight into two smaller objects, one in each hand, instead of carrying one heavy object. If you need to carry something large, keep it close to your body. Sleeping position Sleeping on your back greatly increases pressure on the back. Using a pillow under the knees reduces this load. Sleeping on your side with a pillow between the knees also helps relieve pressure on the spine. How to deal with pain: In most cases, low back pain during pregnancy is temporary and tends to improve over time. Medications should be avoided without medical guidance. Other measures include: • Specific strengthening exercises • Use of lumbar supports • Application of local heat or cold If the pain persists or is accompanied by symptoms such as radiation to the legs, tingling, or weakness, it is essential to seek evaluation from a spine specialist.