Scoliosis Treatment: Recent Medical Advances and Surgical Options

Scoliosis Treatment: Recent Medical Advances and Surgical Options

Recent Discoveries and Developments in Medicine

Recent discoveries and developments in the medical field are providing new options for many diseases. Diseases that profoundly affect people's lives can now be addressed with less invasive surgical procedures. Turkey is among the countries where advances in the treatment of these diseases continue to be made.

Investments in healthcare, newly established city hospitals, and the specialist doctors trained in Turkey contribute to progress in both the treatment and research phases of diseases.

One of these diseases is Scoliosis. In this article we have researched for you, we will try to share answers to the most commonly asked questions about what scoliosis is, how long the surgery takes, and what the risks are. This content is for general information purposes only and does not replace professional medical advice; please consult your physician for any concerns.

What is Scoliosis (Spinal Curvature)?

Curvatures that occur in a person's spine toward the right or left side are called scoliosis, or spinal curvature in common language. These curvatures are generally located in the chest and lower back regions. This condition is commonly observed today.

People affected by this condition may experience more difficult and restricted movements compared to what is typical during daily activities. For this reason, people who experience difficulties and problems in their daily routine often seek information about treatment options.

The curvature of the spine, or scoliosis, has specific degrees. The treatment method is determined according to these degrees. These curvatures generally do not correct on their own; they are addressed through physical therapy exercises, scoliosis-specific exercises, and, when needed, surgical interventions, as determined by a physician.

Scoliosis is a three-dimensional deformity in which the spine shows abnormal curvature. Normally, the spine contains slight curves that help provide balance and carries the body's weight. However, this deformity involves lateral (right or left), anterior-posterior (forward or backward), and rotational orientations of the spine.

Lateral (Right or Left) Curvature:

This is a characteristic feature of scoliosis. While a normal spine forms a straight line, spines with scoliosis can create "S" or "C" shaped curves toward the side. This lateral curvature refers to the extent to which the spine curves toward the sides.

Anterior-Posterior (Forward or Backward) Curvature:

Scoliosis causes abnormal curvatures not only laterally but also in the anterior-posterior plane. This dimension refers to the curvature occurring on the front and back of the spine. While normally the spine creates certain degrees of curves in the anterior-posterior plane, in people with scoliosis, the spine may curve more forward or backward than typical.

Rotational (Twisting) Curvature:

Scoliosis can also cause the spine to twist. This means that the vertebrae rotate in relation to each other and appear to deviate from the spinal line. Rotation is another important characteristic in the three-dimensional structure of the spine. This rotation also affects the ribs at the relevant levels.

The combination of these three-dimensional curvatures determines the overall appearance and severity of scoliosis.

What are the Causes of Scoliosis?

Scoliotic deformity can develop due to many different causes. Among these causes are anatomical, genetic, neuromuscular, and environmental factors. Some factors explaining possible causes of scoliotic deformity can be explained as follows.

Idiopathic Factors (Unknown Causes); Idiopathic scoliosis is a subtype that comprises a large portion of scoliosis cases and whose cause is not fully known. This type of scoliosis, which is common among adolescents, cannot be associated with any specific anatomical cause. Idiopathic scoliosis is divided into subtypes according to age groups (infantile, juvenile, adolescent, adult).

Genetic Factors; Genetic predisposition can play a role in scoliosis development. Family history can increase the risk of scoliosis. Individuals with a family history of scoliosis may have a higher likelihood of developing scoliosis.

Congenital Anomalies; Spinal anomalies that occur before or during birth can be a cause of scoliosis. Congenital anomalies include situations where spinal bones or other spinal components develop differently than normal.

Neuromuscular Factors; Nerve or muscle disorders can affect the balance and control of spinal muscles. These types of disorders can contribute to scoliosis development. For example, neuromuscular conditions such as cerebral palsy and muscular dystrophy can increase the risk of scoliosis.

Environmental Factors; Environmental factors can affect scoliosis development. Incorrect posture habits, improper sitting or sleeping positions, and heavy load carrying can contribute to scoliosis by disrupting spinal balance.

Technology Use; In recent years, the widespread use of technology, particularly the inappropriate postures caused by prolonged computer or smartphone use, can negatively affect spinal health and may be associated with an increased risk of scoliosis.

Scoliosis development can be influenced by multiple factors, and in some cases, the exact cause may not be determined. If there is any suspicion of scoliosis, it is important to consult with a qualified healthcare professional and undergo necessary examinations.

What are the Symptoms of Scoliosis Disease?

It is known that every disease presents differently in each person. This individual variation also applies to scoliosis. This condition, which shows few symptoms in its early stages, may be associated with other issues if diagnosed late. For this reason, if any one or several of the symptoms listed below are present, it is advisable to consult a doctor for evaluation and, if scoliosis is present, to seek early diagnosis and guidance on treatment.

Scoliosis can have different degrees and different symptoms at each degree. The most commonly reported symptoms include:

• The person's spine beginning to curve toward the right or left side,

• One shoulder being higher or lower than the other, which can cause an asymmetrical appearance in the shoulders.

• A visible curve in the person's spine that can be noticed from the outside,

• If the curvature progresses, a distinct spinal curvature or lateral curve may become visible. This curvature may resemble an "S" or "C" shape.

• In more advanced scoliosis, as a result of spinal rotation, one side of the ribs may protrude more, which can make the back appear more prominent when viewed from the outside.

• An asymmetrical appearance in the person's shoulder and hip,

• One hip being higher or lower than the other, which can cause an asymmetrical appearance in the hips.

• When viewed from the front, one side of the right and left waist curves may appear deeper than the other.

• Difficulty maintaining an upright posture,

• Poor posture habits may develop in people with scoliosis. Leaning forward or other postural changes may be noticed.

• Breathing difficulties,

• When scoliosis is more advanced, the rib cage can become restricted and respiratory difficulty can occur.

• Some difficulties may be experienced while walking,

• Pain occurring in the lower back, shoulder, or back area,

• Scoliosis is often painless, but more pronounced curvatures can be associated with back or lower back pain in some individuals.

• If the curvature progresses, properly fitting clothing may become more difficult, with dresses or pants fitting asymmetrically.

• Clothing not fitting as it did before can also be among the reported changes.

• More advanced scoliosis may contribute to fatigue, as muscles work harder than usual to maintain the spine's balance.

If there is suspicion of scoliosis or any of these symptoms are observed, it is important to consult with a healthcare professional. Early evaluation may help in monitoring or managing scoliosis progression; please consult your physician for guidance specific to your situation.

What are the Degrees of Scoliosis?

The degrees of scoliosis in patients are typically assessed using computed tomography, radiography, and MRI methods.

These degrees are generally examined in three categories: mild, moderate, and severe. If the degree of curvature in the spine is 10 degrees or less, it is not classified as scoliosis. The condition at this degree is referred to as spinal asymmetry.

Stages are classified according to the severity of the spine's curvature. A commonly used classification system is based on the Cobb angle, which is used to determine the degree of spinal curvature. The Cobb angle is the angle between the two most curved points of the spine, and scoliosis is generally divided into different stages according to this angle.

Mild Degree Scoliosis; When the curvature in a person's spine is 20 degrees or less, it is considered mild degree scoliosis. At this degree, doctors generally do not initiate treatment, but monitoring the progression of the curvature is recommended.

Moderate Degree Scoliosis; Scoliosis measurements ranging from 20-40 degrees are called moderate degree scoliosis. This degree, typically diagnosed in children aged 10-15 years, is generally managed with physical therapy and brace treatment as determined by the physician.

Severe Degree Scoliosis; At a measured value of 40 degrees and above, because the spinal curvature is more pronounced, the physician may consider surgical intervention at this stage.

Very Severe Degree Scoliosis (More than 50 Degrees); If the degree of curvature is more than 50 degrees, this stage is referred to as very severe scoliosis. At this stage, there can be notable effects on the spine's shape and the person's quality of life. Surgical intervention may be considered more frequently, based on the physician's evaluation.

While the Cobb angle is used as the basis, different measurement methods and classifications may also be used in determining the degree of scoliosis. Since each individual's situation differs, the treatment and intervention plan is tailored according to the individual's age, health status, symptoms, and degree of curvature. For this reason, individuals diagnosed with scoliosis should be closely monitored by a healthcare professional.

What are the Risk Factors of Scoliosis Disease?

If we need to discuss the risk factors of scoliosis in detail, we can provide the following information:

• Family history can increase the risk of scoliosis. If you have a family history of scoliosis, your likelihood of developing scoliosis may be higher.

• Adolescence is one of the most common periods for scoliosis to develop. During rapid growth spurts, the risk of spinal curvature can increase.

• Girls are generally reported to have a higher risk of developing scoliosis than boys. However, in more severe cases, this gender difference may be less distinct.

• Conditions called congenital scoliosis result from abnormal spine development before or during birth. These types of abnormalities can increase the risk of scoliosis.

• Neuromuscular conditions such as cerebral palsy and muscular dystrophy can affect spinal control and increase the risk of scoliosis.

• Incorrect posture habits, poor sitting or sleeping positions, and carrying heavy backpacks can contribute to spinal disorders and increase the risk of scoliosis. Some studies suggest that smoking may increase the risk of scoliosis. Additionally, excess weight may increase the risk by placing additional strain on the spine.

• Prolonged computer or smartphone use and postures that may harm spinal health can be associated with an increased risk of scoliosis.

• Hormonal changes, particularly during adolescence, can affect the growth rate of the spine and may be associated with increased risk of scoliosis.

Scoliosis risk factors can vary for each individual, and sometimes the effects of multiple factors can combine. Regular health checkups may help with early detection. If you think you may be at risk for scoliosis, it is important to consult with a healthcare professional and undergo necessary examinations if needed.

How is Scoliosis Diagnosed?

Scoliosis diagnosis is generally made through physical examination, imaging tests, and specific measurements. Below are some methods used in diagnosing scoliosis:

Physical Examination: The doctor evaluates the patient's posture and spinal shape. The doctor checks whether there is any asymmetry or curvature in the alignment of the shoulders, waist, and hips. Additionally, the doctor may examine forward bending in specific positions (bending test) and spinal rotation.

Cobb Angle Measurement: This measurement is one of the fundamental tools used to evaluate scoliosis curvature. On X-ray images, the angle between the two most curved points of the spine is measured. This Cobb angle indicates how much the spine is laterally curved.

Rotation (Twisting) Angle Measurement: This measurement is performed using a scoliometer during the forward bending test to determine how much the spine rotates in the horizontal plane.

Imaging Tests: X-rays, MRI (magnetic resonance imaging), or CT scans are imaging methods that help examine the spine in detail. These imaging tests are used to better understand the shape of scoliosis, its degree, and possible causes.

Postural Analysis: The person stands in specific positions and body posture and asymmetry are evaluated. This can help detect early stages of scoliosis.

Clinical Evaluation: Especially in children, growth rates and spinal development are monitored regularly. The doctor may closely monitor children showing potential scoliosis symptoms.

These methods are usually used together to support a scoliosis diagnosis. Proper diagnosis is important for monitoring scoliosis progression or determining a treatment plan in consultation with a physician. If there is suspicion of scoliosis or if you have concerns about this matter, you should consult a qualified healthcare professional.