Scoliosis

Scoliosis

Scoliosis is fundamentally a progressive condition that is typically characterized by cosmetic problems in the lower and upper back, and in severe cases, it may present with respiratory and cardiac issues. Normally, when viewed from behind, the spine appears as a straight line, but in scoliosis, it presents as an S-shaped curvature. It mostly occurs during adolescence but can be seen at any age.

Symptoms:

Asymmetry in the body leaning to the right or left Uneven shoulder levels A noticeable bulge in the back when bending forward (rib hump) Asymmetry in skin folds

Types:

Congenital scoliosis Idiopathic scoliosis Early-onset scoliosis Scoliosis due to trauma Degenerative scoliosis Neuromuscular scoliosis Others

Diagnosis:

Diagnosing scoliosis relies significantly on careful observations by parents, as they are the ones who know their child best. A small observation made while the child’s upper body is bare and X-ray imaging can be used for diagnosis. A comprehensive X-ray covering the entire spine and measurements taken from this image can help diagnose scoliosis. However, for a more comprehensive understanding of the cause, an MRI and CT scan of the entire spine should be conducted.

Treatment:

Treatment options vary depending on the type of scoliosis, its cause, the patient’s age, the location, and degree of the disease. All these factors, along with radiological imaging, will determine the personalized treatment options for the patient. Early detection leads to higher success rates in treatment, as in most medical conditions. There are two main treatment approaches:

Observation, bracing, and physical therapy applications Surgical treatment

• Observation, bracing, and physical therapy applications:

Based on the patient’s age and degree of curvature, regular X-ray monitoring is necessary, typically within the range of 0-20 degrees. Bracing applications can be considered for curvatures between 20-40 degrees. For curvatures in the range of 0-40 degrees, scoliosis-specific exercises (Schroth exercises) and conditioning can be applied.

• Surgical treatment:

For curvatures exceeding 40 degrees, surgical treatment should be considered. The materials used in surgery are screws and titanium rods. During surgery, neuromonitoring (nerve imaging) is performed to ensure the safety of the procedure by confirming healthy nerve transmission. Patients begin walking the day after surgery, and they can return to their regular activities in about two weeks.

Advancements in Diagnosis and Treatment:

Genetic analysis can determine whether the disease will progress rapidly or slowly.

Anterior Tethering Surgery:

Developed as an alternative to standard screw-rod surgery for scoliosis patients requiring surgical treatment. This surgery preserves flexibility completely with small incisions and is known as a “string surgery” in popular terms.