Scoliosis
It is a lateral curvature of the spine that can be seen mostly in the thoracic and/or lumbar regions. It can be seen alone or together with kyphosis (humpback; an abnormal curvature from back to front) (Kyphoscoliosis). The vertebrae (bones that make up the spine) that extend straight from top to bottom in the normal spine rotate to the right, left and/or around their own axis in the spine with scoliosis.
The disease is much more common in girls. Especially, scoliosis exceeding 30 degrees is seen ten times more in young girls than in boys.
Scoliosis is the sideways bending of the back or waist regions of the spine. Sometimes it is accompanied by an increase in the normally existing hump on the back or the dimple in the waist. The reason for the formation of scoliosis; It could be due to many different reasons. Congenital, spastic children may be due to idiopathic (unknown cause) infection or tumor. Familial predisposition is present in all idiopathic ones.
Why does scoliosis occur?
Scoliosis can occur due to many different reasons. However, the scoliosis that we encounter frequently in our daily lives are idiopathic scoliosis, which appear mostly at the age of 10 and whose cause is not yet known, and congenital (congenital) scoliosis that occur due to factors in the mother’s womb and present from birth. It is thought that the main factors in congenital scoliosis are infections during pregnancy, diabetes and some vitamin deficiencies.
What are the major types of scoliosis?
There are 3 types of scoliosis;
- Congenital (congenital); usually due to a developmental defect in the spine or fused ribs.
- It can occur as a result of paralysis of the muscles due to conditions such as polio (polio), cerebral palsy or muscular dystrophy.
- Unknown (Idiopathic); It can occur for an unknown reason in a previously smooth spine.
What are the syptoms of scoliosis?
- Lateral curvature of the spine
- Lateral and anterior curvature of the spine
- Progression of one shoulder (right-left)
- Shoulders and hips are not symmetrical
- Presence of a second curve to compensate for the first curve
- Back and/or low back pain
- Shortness of breath, tiredness
How is Scoliosis diagnosed?
Early detection of scoliosis and referral to a physical therapy and rehabilitation clinic or hospital where scoliosis will be followed is essential. Many scoliosis can be treated without surgical intervention if detected before it progresses. For him, school screenings are very important. Exercises as a treatment should not be considered as the only treatment option. In other words, you cannot give the patient exercise programs and send them. Because bracing (orthoses) should be performed according to the degree of curvature in these patients or they should be referred to surgery if necessary. Well-performed bracing can provide an improvement of 70 percent if cooperation with the patient and the patient’s family can be achieved.
Diagnosis is made based on both examination findings and radiological examinations (X-ray, Magnetic Resonance Imaging, Computed Tomography, etc.). During physical examination, the curvature appears more pronounced when the patient leans forward than in the standing position. X-rays of the spine in different positions (antero-posterior, lateral, leaning to the sides,…) and scoliosisometry (an instrument that measures the amount of curvature of the spine) are the most important diagnostic methods used to determine the amount of scoliosis.
How is scoliosis treatment performed?
Effective in deciding on treatment; There are many factors such as the amount of curvature (degree), the type of scoliosis and the stage of bone growth.
Early diagnosis is very important for the success of the treatment of scoliosis patients, as early initiation of treatment affects the results positively.
The diagnosis of scoliosis is made with an x-ray graph showing the entire spine, and an MRI is required to investigate whether there is any other problem with it. It may be different for each patient in its treatment, but it may vary mainly depending on the progression rate of scoliosis, the degree of curvature, and the presence of additional pathologies.
NON-SURGICAL SCOLIOSIS TREATMENT
Corset Treatment: It is done in children where the curvature is above 25 degrees and growth continues. The effect of the corset is not valid in curves above 40 degrees and in those who have completed their growth.
SURGICAL TREATMENT
Surgery is the most appropriate treatment method in patients with continued growth and curvature greater than 40 degrees (>40°). In these curvatures, surgical treatment is performed to prevent complications and for cosmetic results.
Congenital scoliosis treatment can be done at younger ages and degrees. In the surgical treatment, the spine is straightened with the help of screws and rods placed on the back and/or waist. Today, developments in surgical techniques and auxiliary methods such as imaging of spinal cord functions (neuromonitorization) applied during surgery are very useful in reducing the problems that may occur in the patient during surgery and increase the success of the surgery. Clinics in Turkey have these infrastructures in modern spine surgery centers and scoliosis surgeries are successfully performed by globally renowned surgeons.