Joint Prosthesis Surgery
Spinal Curvature - Scoliosis
Hand And Finger İnjuries
• Prof. Erdal CİLA, MD
• Assoc. Prof. İbrahim AKEL, MD
• Levent TAD, MD
• Serdar SÖYLEV, MD
SPINAL CURVATURE- SCOLIOSIS
Curvatures in spine constituting back and lumbar region are called as “scoliosis”. Health spine is straight front and rear. If we look laterally, there is a slight back bulge accompanying with concavity of neck and lumbar region. In scoliosis, curvatures towards right and/or left are observed in the spine when we look from the rear and front.
Scoliosis can be seen from early infancy period to adult age all the time. Course of disease and treatment options differ by the age, type and location of curvature. Considering reasons by types of scoliosis, there are a number of factors including heritability, nerve-muscle-bone balance disorders, hormonal reasons.
The reason of affecting vital functions of spine and thoracic cage deformities in scoliosis is that curvature when progressed may deteriorate heart and lung capacity and result in significant systemic problems. For this reason, early diagnosis and treatment is significant for this disease like many diseases. While some curvatures by type, location and degree of curvature are followed closely and a treatment is not administered, exercise and corset options and also surgery methods are among treatment options.
How is scoliosis diagnosed?
Asymmetry of shoulders, thoracic cage and waist indentation and shift of body can be observed in scoliosis patients by degree of curvature in back spine, level and type. In patients that scoliosis is observed in adolescence period, curvature of back and lumbar region may increase and become clear in fast growing period between the ages of 11-13. In the scoliosis occurring in advanced ages, curvatures due to wearing and deterioration of adult spine and lumbar and back pain may occur.
In scoliosis developing in growing period, families may note scoliosis disease by unilateral wide bulge in back and height difference in waist indentation, height differences between shoulders of children. In addition to this, stooping test is significant for diagnosis of disease. In this test, child leans forward without bending the knees as feet are joined. Difference between heights on left and right side of back from above is a significant indicator for the diagnosis of scoliosis covering back spines especially. In addition to spine graphy and computed tomography (CT) and magnetic resonance imaging (MRG) methods can be used to recognize and type back curvature.
If childhood age scoliosis disease is diagnosed in early period, problems to be seen in advanced ages can be prevented by non-surgical or surgical procedures. While there are different treatment methods for growing children for every age, the common purpose is to maintain curvature within acceptable limits and stop it. For the curvatures in advanced stage, the purpose is to correct curvature and maintain it.
Course and characteristics of scoliosis disease vary by the types of occurrence. In “congenital scoliosis” formation/adhesion disorder in back and lumbar spine congenitally, the disease occurs in early ages mostly and may progress fast. Formational problems may be observed in the internal organs of these children. In “infancy scoliosis” another type seen in the first years of birth, formation and adhesion disorder of spine is not observed and generally mild curvatures progress benign and improves itself within 1-2 years. “Early childhood age scoliosis” is noted between the ages of post-infancy and pre-school age. Corset treatment is administered or the operation is performed by the degree, location and severity of the curvature.
Curvatures developing in early age, not improving itself or by means of a corset can be treated with surgical procedures to be carried out in early ages most of the time. By new systems adapted to growing spine, congenital and early childhood scoliosis can be treated with minor series of operations and damaging the spine less.
Scoliosis from childhood age to adult age is another type of disease. Back curvatures noted following an excessive increase in the age including the second fast growing period of childhood age can be observed. Different treatments from untreated close follow-up of curvature to corset and exercise treatment may be necessary and for excessive curvature progress of which can’t prevent by these methods, curvature is corrected by operations to be carried out next to back and thoracic cage and curved region can be frozen.
As a conclusion, early diagnosis and treatment of this disease deteriorating life quality and body image if ignored is very significant. For this reason, families should take their children to the physician as soon as possible when they note the back curvature. Curvature noted in early period can be treated with minor procedures before progressing and resulting in heart and lung problems.