Shardlake: what is scoliosis and how is it treated?

The Disney series Shardlake is a mystery drama following the journey of Matthew Shardlake (Arthur Hughes), a barrister navigating Tudor England during the reign of Henry VIII. Shardlake’s character has scoliosis, a condition characterised by an irregular sideways twist of the spine, resulting in a visibly curved back with misaligned hips and shoulders.

Set against the backdrop of 16th-century England, Shardlake’s story unfolds in an era long pre-dating X-rays, which let us view the structure of the spine. Consequently, the understanding and treatment of conditions like scoliosis were rudimentary at best.

Historical remedies ranged from stretching, pulling and twisting the spine – and even being stepped on. Surgery was not attempted until 1865, when Jules René Guérin, a French surgeon, attempted to reduce spinal curvature by cutting tendons in the spine. The outcome for the patients was dire.

Thankfully, the trajectory of medical advancement has propelled us far beyond such antiquated practices. The emergence of X-rays and other imaging technology, such as magnetic resonance imaging (MRI), has revolutionised our ability to visualise the structural intricacies of spinal deformities such as scoliosis.

Our understanding of how biological processes govern tissue function and structure,........

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