What is Scoliosis?
In normal and healthy spine, when the vertebrae are viewed from the back, there is a straight line image in the neck, back and waist regions from top to bottom.
Scoliosis is the bending of the spine more than 10 degrees to the side when viewed from the front or the back. In scoliosis, the vertebrae are displaced to the right or left and at the same time rotate around their own axis. For this reason, it is defined as a three-dimensional deformity.
Scoliosis is most common in the back and lumbar regions of the spine and may involve one or both of these regions. The most common form of curvature is the curvature of the right side of the chest.
What are the Causes of Scoliosis?
Scoliosis can occur due to many different underlying diseases. Many factors such as congenital defects in the formation of spinal bones, defects in the bones of the rib cage, nerve and muscle diseases, spinal tumors, trauma, spinal infections, metabolic diseases, and surgeries in areas close to the spinal bones can cause scoliosis.
The most common form is scoliosis of unknown cause (idiopathic).
Studies show that scoliosis is a genetic disease and studies are still ongoing to distinguish the genes that cause scoliosis. "Carrying a heavy bag", which is widely known among the people, is not a factor that causes scoliosis.
What Physical Changes Can Scoliosis Cause?
One shoulder is higher than the other. One more scapula (scapula) is protruding. One hip is higher than the other. One leg may appear longer. There is asymmetry in the waist, the waist pits are unequal. The torso and rib cage have shifted to one side. The head is not centered between the hips. Dresses do not fit neatly and one side appears higher when the child bends down from the waist.
What are the Treatment Methods in Scoliosis?
Scoliosis can be treated with surgical or non-surgical methods, depending on the size and severity of the curvature. Non-surgical methods include observing the progress of the curvature with physical therapy and exercises, using a corset and following with casting. The surgical decision depends on the stage of growth, the location of the curvature and the shape of the curvature. There are several different scenarios for curvatures between 25-40 degrees.
If the curve has worsened but is still less than 40 degrees and growth is complete, there is a low risk of progression of such curves into adulthood. If the curvature has worsened but surgery is not recommended and still continues to enlarge, then close observation is required and the use of a brace may be considered.
If a curvature reaches 40 degrees, surgery may be recommended even if growth is not complete. When the skeleton matures, curves less than 40-45 degrees in the dorsal region tend to progress less, but lumbar curvatures have a lower threshold value of 35-40 degrees.
Curvatures greater than 50 degrees when the skeleton matures have a risk of progression through adulthood, but progress at a slower rate (about one to two degrees per year).
Surgery is likely to be recommended. The aim of surgery in scoliosis is to prevent further progression of the deformity and to straighten the spine in the safest way possible. Stopping the progression will also prevent serious health problems that come with severe scoliosis in the later years of life.
Some of the problems that may accompany large curves are breathing difficulties, heart problems, muscle weakness and pain. In short, a smooth and balanced body and spine are obtained with surgical treatment. The surgical procedure to be performed will be determined by the specialist physician depending on the type of scoliosis, the degree of curvature and the potential to increase, and the age of the patient.
During surgery, the curvature is corrected as much as a safe correction is possible. To do this, implants (usually rods, screws, wires and/or hooks) are attached to the vertebrae in the part of the spine where the curvature is.