What is Deformity?
It is a general term used to describe the bending and deformities of the bones.
Spinal deformities can cause serious and life-threatening health problems, as well as physical problems such as poor posture and gait in many people. In order to treat these types of diseases, which are also called spinal deformities in medicine, it is necessary to fully understand the deformity with various imaging and measurement methods. Spinal curvature, known as scoliosis, accounts for approximately 80% of structural deformities. Depending on the degree of curvature, the picture of scoliosis may not be noticed for many years, and may require urgent intervention by putting pressure on the lungs. If the disease is detected late, growth and developmental retardation occurs, especially in childhood, along with various health problems. For this reason, it is extremely important to have sufficient information about scoliosis and to be able to recognize the signs and symptoms at an early stage in terms of the course of the disease.
Scoliosis – What is Curvature of the Spine?
Scoliosis; It is a three-dimensional spinal deformity that is the most common among spinal deformities and causes extremely serious posture disorders in the progressive stages. This deformity may occur due to the structural defect of the spine, or it may develop due to non-spineal causes. Nonstructural scoliosis usually resolves partially over time or becomes unrecognizable when the root cause of the scoliosis is eliminated. Structural scoliosis often occurs idiopathic, but neuromuscular diseases, connective tissue disorders, infectious or neoplastic conditions, neurofibromatosis, degenerative and rheumatic diseases, metabolic disorders and various traumatic effects can also cause structural curvature of the spine.
What is Idiopathic Scoliosis?
Scoliosis tables in which the factor causing the structural curvature of the spine is not known is called idiopathic scoliosis and approximately 80% of all scoliosis are in this group. This complex spinal pathology, which is thought to occur due to more than one factor during the rapid growth period of childhood, is usually painless and asymptomatic. Therefore, it is very difficult to detect. In cases that progress without diagnosis in the early period and cannot be treated, acute or chronic back and waist pains occur, heart and lung functions deteriorate, and physical movement limitation is observed. Because of the cosmetic defect, the risk of depression increases and the person's quality of life is greatly impaired. Severe curves have a high risk of sudden death.
Idiopathic scoliosis is generally classified into 4 different groups according to the age at which the curvature is noticed: infantile (0-3 years old), juvenile (3-10 years old), adolescent (10-18 years old) and adult (18 years and older) scoliosis. While infantile scoliosis is extremely rare at a rate of 1%, the incidence of juvenile scoliosis is around 11-16%. Adolescent scoliosis, also known as late-onset scoliosis, which occurs around adolescence, is responsible for approximately 90% of all scoliosis cases.
What Causes Scoliosis?
The cause of idiopathic scoliosis, which occurs in 2 to 4 of every 100 healthy children, has not been fully explained. However, some factors associated with the occurrence of the disease can be listed as follows:
What are the Symptoms of Scoliosis?
Scoliosis starts very insidiously and can progress without any symptoms for a long time. There is usually no pain and most of the cases are discovered incidentally on radiographs taken for other reasons. However, people with loss of flexibility in the hamstring muscles, decreased bending capacity of the spine, and weakness in the abdominal and back muscles may experience severe low back pain as a result of certain physical activities. However, considering the relationship of the spine with the rib cage, people with severe curvature complain of shallow breathing and frequent respiratory tract infections due to decreased chest compliance. It should be known that progressive and untreated cases increase the person's susceptibility to depressive mood and various mental illnesses, and spinal curvatures above 90° are associated with sudden death syndrome.
Scoliosis Treatment
Early diagnosis is the first step in the treatment of idiopathic scoliosis. With early diagnosis, it is aimed to prevent the progression of curvature, especially in adolescence, to reverse the spine at an optimal angle, and thus to improve both aesthetics and posture. The aim of advanced scoliosis treatments is primarily to alleviate the pain complaint in the spine, to improve the accompanying physical problems and to correct the deterioration in respiratory function.
When planning the treatment, many factors such as the person's age, gender, presence of concomitant diseases, degree of spinal curvature, direction and type of curvature, and the risk of progression of scoliosis are taken into consideration. Apart from surgical treatment, conservative treatment methods such as the use of corsets and specific exercise applications for scoliosis are preferred. However, in order to prevent serious spinal injuries, each patient should be evaluated individually and the remedial methods to be applied should be determined individually according to the clinical characteristics of the patient.
Scoliosis Exercises
Exercises developed for scoliosis are one of the conservative treatment methods applied to strengthen the spine and stop the progression of the curvature. The most preferred technique is a three-dimensional exercise technique called the Schroth Method, which corrects posture by eliminating the asymmetrical load distribution of the body. Thanks to these advanced exercise practices, which are specific to each individual, planned in line with the curvature of the spine and supported by various breathing techniques, the flexibility of the muscles in the affected area is increased, while the muscle strength, balance level, mobility and general coordination level of the body are supported.
Scoliosis exercises should be performed from the beginner level with therapists who are familiar with the Schroth technique and who are familiar with specific exercise practices related to scoliosis. While planning the exercise, the direction of the spinal curvature and the current treatment phase are taken into consideration. In order to correct the curvature of the spine with the Schroth method, certain exercises should be repeated at regular intervals in line with the personal plan. For this reason, the patient should take care to work in harmony with the therapist from the beginning level; To increase the success of the treatment, the exercise plan should be strictly followed.
In addition, the use of corsets is one of the most preferred methods for the treatment of scoliosis. Stabilization and mobilization exercises for 35-40 minutes a day performed with the corset increase the effectiveness of the corset and have a healing effect on the spinal deformity. In addition, the use of corsets supported by regular exercise practices greatly reduces the need for surgical intervention in the treatment of scoliosis. It helps control post-operative pain and support spinal function.
Surgical treatment method is preferred for scoliosis tables that continue to progress despite conservative treatment methods such as exercise and corset, and whose spine curvature level is above 45°-50°. After scoliosis surgery, which is one of the most serious operations, close follow-up is required for a certain period of time. While it takes 3-4 weeks for the person to return to daily life activities after the operation, it becomes possible to perform all kinds of physical activities within 3-6 months after the operation. Although highly successful scoliosis surgeries are performed today, various complications such as paraplegia, increased kyphosis, pseudoarthrosis, late-onset pain complaints, overcorrection, flat back syndrome, increased deformity, infection and rotational deformity may occur due to scoliosis surgery. In order to minimize such complications related to surgery, take care to choose experienced physicians and surgically equipped health centers.
