What is Scoliosis?
Scoliosis is defined as the curvature of the spine over 10 degrees to the right or left, which should normally be placed in a straight line when viewed from the back. Scoliosis is not just a one-dimensional angular deformation, but a bone and structural deformation that affects the body in three dimensions, from the front and from the side.
Scoliosis is a condition that can be seen in every period of life. Genetic transition can cause scoliosis.
If the scoliosis angle is high, the visual impact of the body is very disrupted. This shape disorder affects these young children at the beginning of the adolescence period not only as a health problem, but also visually, disrupting the confidence in their own bodies and causing psychological problems. Apart from shape disorder, as the angle of curvature of scoliosis increases, complaints such as shortness of breath, swelling, fatigue, especially due to the compression of the lungs and heart in the chest, and can cause pain. As a result, it can negatively affect the quality of life.
What are the Types of Scoliosis?
Idiopathic scoliosis (Scoliosis of unknown cause)
The most common type of scoliosis; It is idiopathic scoliosis, the cause of which cannot be fully clarified. Lateral bending in the spine can be ‘S’ or ‘C’ shaped. Apart from tilting to the side, rotation of the vertebrae around themselves is also seen in all idiopathic scoliosis, including the mildest forms. This rotation in the vertebrae causes asymmetric protrusions on the back or waist. Genetic and environmental factors are emphasized in its etiology. It is 8-10 times more common in girls during adolescence.
The second most common type of scoliosis is neuromuscular scoliosis. The main reason of neuromuscular scoliosis is the underlying muscle and nerve disease. Nerve diseases can originate from the brain and spinal cord; Muscular diseases can be seen in childhood and later. It can be seen in cerebral palsy (CP), polio, meningomyelocele, muscular dystrophy, and tethered cord syndrome.
In neuromuscular scoliosis, unlike idiopathic scoliosis, respiratory distress and sensory defects are more common.
Congenital scoliosis is the third most common. It is a type of scoliosis due to spinal anomalies that occur during the development of the unborn child. Congenital scoliosis progresses rapidly in the early years. For this reason, the treatment process of congenital scoliosis that occurs in the early stages may require surgical intervention at a young age. There is no gender discrimination. It cannot be explained exactly why congenital scoliosis occurs. Due to a number of events that occur during the development of the embryo and fetus, some conditions can be seen more frequently with congenital spinal deformities.
Adult idiopathic scoliosis
Beginning painlessly in childhood; However, it is a condition that can show its symptoms (pain, posture disorder, etc.) in advanced ages. In adult idiopathic scoliosis, severe pain may occur due to degeneration in facet joints. Respiratory functions may be affected due to excessive deformation that may occur in the chest, and patients may get tired quickly and respiratory distress may occur.
Adult degenerative scoliosis
Adult degenerative scoliosis is the type of scoliosis that occurs as a result of wear on the spine with aging. It usually occurs in people over the age of 50. Also, osteoporosis that occurs at these ages may be one of the causes of degenerative scoliosis in adults as well as increase in curvature. Degenerative scoliosis that occurs with wear can be seen in any of the neck, back and waist regions of the spine; However, the most common area is the waist region.
What are the Symptoms of Scoliosis?
Scoliosis does not cause any health problems in the early period, very rarely, back pain can be seen. Therefore, it can be difficult for families to notice if not careful. Symptoms of scoliosis are visual features such as one shoulder higher than the other, hip sliding to the right / left, or hip elevation on one side, and inequality in the posture of the shoulder blades. The best method that families should do regularly is to ask the chıld to lean forward with the bare back of the child and visually examine whether the spine is on a straight line. At the end of such a control, if there is scoliosis, a protruding height on the right or the path of the back or in the waist area will be noticeable. The scoliosis may sometimes be accompanied by color changes on the skin.
Another situation that families should be aware of is that scoliosis can be seen at the age of 10-16 years and since it is not known when it will occur, this spine check should be done frequently. Particular attention should be paid to children with signs of puberty. When scoliosis is suspected, a physician should be consulted immediately.
What is Done at the Diagnosis Stage in Scoliosis?
After a detailed history is taken and examined by the physician, imaging methods are used. It is possible to make a definite diagnosis with standing spine radiographs. Rarely, advanced radiological examinations (MR films) of the spine are also ordered to distinguish other causes. There are body topographic analysis systems that do not contain X-rays, which have been used more frequently in recent years, that allow following curvature.
Early diagnosis is the most important in scoliosis. For this reason, families should check the spine of their children between the ages of 10-16, and if there is any doubt, they should consult a physician immediately.
What Are The Treatment Steps In Scoliosis?
There are some algorithms determined in scoliosis treatment. If it is detected early, if it is detected at a low angle, it is a candidate for conservative (protective) treatments. Treatments for scoliosis include observation, physiotherapy and rehabilitation applications, corseting and surgery.
The treatment of scoliosis is determined by the degree of curvature and the stage of growth. Today, the accepted non-surgical treatment methods are scoliosis-specific exercises, special scoliosis programs and corset application. The main purpose of the treatment of scoliosis is to prevent the progression of the curvature, to protect the mobility of the child’s spine, to control cosmetic deterioration and to prevent surgery.
Exercise practices are extremely important in scoliosis. Three-dimensional scoliosis exercises known and becoming widespread as Schroth exercises are planned individually for each individual according to the affected body part. The aim is to control the pelvis and the muscles and ligaments around the affected spine and to control the body cosmetics. For this purpose, mobilization, spine traction, flexibility and correct posture control and control of the spine in daily life activities are taken as a basis. Regular exercises, correct and biomechanical control of the corset for the appropriate period of time increase the postural balance of the child and control the progression of the angle in scoliosis. Breathing techniques are also included in scoliosis exercise programs. Spinal exercises, which have come to the fore in recent years, offer device-supported programs that allow them to work in a computer-like environment by integrating them into a game-like environment. With Valedo, it is possible to exercise in a standing, sitting position and plank position.
Surgical treatment is applied if the Cobb angle is above 40 degrees in individuals with high risk of progression, as mentioned above, and conservative methods fail. In scoliosis surgery, the spine is taken in the midline with plates and screws and the progression of scoliosis is controlled. In young children, the operation may need to be repeated at regular intervals to ensure the extension of the spine.