ВТОРОЕ МЕДИЦИНСКОЕ ЗАКЛЮЧЕНИЕ
What is Scoliosis (Spine Curvature)?

Scoliosis, which is characterized by the curvature of the spine to the right or left, is a common orthopedic problem today. Due to the restriction of mobility and various symptoms of the disease, people may experience difficulties in their daily lives. The treatment of the disease with varying degree of curvature is planned according to this degree and symptoms. Spinal curvature, which has a very low probability of spontaneous recovery, can be treated with physical therapy, scoliosis exercises and surgical interventions.

What is Scoliosis (Spine Curvature)?

Deformities and lateral curvatures in the waist and chest regions of the spine are the answer to the question of what is scoliosis. Spinal curvature, which is an orthopedic disorder, can occur alone or together with kyphosis or humpback. Although the causes of scoliosis are not known exactly, it may occur due to disorders such as cerebral palsy. However, congenital or acquired scoliosis can also be caused by vitamin deficiencies, diabetes, spinal injuries, infections and hereditary factors.

Onset of Scoliosis

The onset of scoliosis can occur anywhere in the spine. Scoliosis, which can occur at birth or later, can affect people of all ages; however, it usually occurs during adolescence. Symptoms such as swelling on the back, asymmetric stance of the shoulders and hips are effective in the initial understanding of scoliosis.

Scoliosis Disease Symptoms

Scoliosis symptoms, which are not very obvious in the early period, may cause different health problems in the later periods. Since back pain is the most common symptom, patients often search for scoliosis pain. Symptoms of scoliosis that vary from case to case, depending on the severity and type of scoliosis, are:

    • Bending the spine to the right or left side,
    • Visible curvature of the spine,
    • Asymmetry in the shoulders and hips,
    • Difficulty standing upright
    • Shortness of breath
    • Problems in walking
    • Back, waist and shoulder pain,
    • The clothes do not fit the body properly.

Diagnosing Scoliosis

Early diagnosis of scoliosis allows the treatment to give much more positive results. For this, thanks to school screenings, especially in adolescents, there is a chance to intervene in scoliosis without the need for surgical operation.

In adults, a physical examination is necessary for the diagnosis of scoliosis. During the examination, patients are asked to bend forward in order to see the curvature. At the same time, the curvature is visible when the patients are standing.

In the diagnosis of scoliosis, imaging methods are used as well as examination findings. The degree of scoliosis is determined according to the x-ray results of the patients leaning forward, sideways or backwards. Along with X-ray, magnetic resonance (MR) and computed tomography (CT) are also used in diagnosis. MRI is generally used in patients with symptoms such as pain in the leg and back regions and intestinal problems. However, in scoliosis with curvatures greater than 40 degrees, computed tomography is required to better see the bone and spine.

How is Scoliosis Diagnosed in Babies?

Although scoliosis is usually seen in adolescence, it can also occur in infants. For this reason, many people wonder what causes scoliosis in babies. Since congenital scoliosis, also known as congenital scoliosis, is progressive, early diagnosis is of great importance. Symptoms such as abnormal protrusions on the back, skin color changes and hair growth on the back area are seen. At the same time, imaging methods, especially x-rays, are used in the diagnosis of scoliosis in infants.

Scoliosis Grades

Spinal curvatures are measured in degrees. For the discomfort to be called scoliosis, the curvature must be 10 degrees or more. Curvatures of 10 degrees scoliosis and below are spinal asymmetry, not scoliosis.

Scoliosis grades are divided into three as mild, moderate and severe. Mild scoliosis is curvature less than 20 degrees. A 20 degree scoliosis image usually indicates that no treatment is needed. However, patients should go to regular check-ups in order to understand whether there is an increase in the curvature.

Curvatures between 20 and 40 degrees are called moderate scoliosis. The appearance of 20 or 30 degree scoliosis, which is mostly diagnosed between the ages of 10-15, can be improved with corsets and physical therapy.

In severe scoliosis, the curvature is over 40 degrees. Since the appearance of 40 degrees scoliosis and the curvatures above it show severe symptoms, most patients are treated with surgery.

How is Scoliosis Grade Calculated?

Scoliosis grading is done by imaging methods. Computed tomography, radiography and MRI are the methods used in grade calculations.

When Does Scoliosis Progress Stop?

Most people with spinal curvature are investigating whether scoliosis will progress. Although scoliosis is a disease that cannot be prevented, the progression of the disease can be stopped with various treatment methods and age. Until what age does scoliosis progress, it is one of the curious points. Scoliosis, which generally occurs at a young age and progresses until the end of adolescence, either stops completely or slows down very slowly in adulthood.

What Scoliosis Patients Should Not Do

Due to scoliosis types and spinal curvature, patients should stay away from certain activities. Especially adults suffering from scoliosis can have a more successful treatment process by paying attention to the mentioned points.

Although regular exercise is recommended for all scoliosis patients, first of all, people should avoid doing very heavy exercise. Exercises that strengthen the back muscles and help reduce pain also increase the mobility of people. Especially swimming, yoga and pilates are thought to be effective in the treatment of scoliosis. It is beneficial to stay away from compelling sports activities such as long-distance running or horseback riding that may put pressure on the spine. Especially people who have had scoliosis surgery should avoid multi-contact sports that can cause trams.

Scoliosis patients can also prevent the increase in curvature by making some changes in their daily lives. Working at a desk for a very long time is one of the movements that should be avoided. However, in order not to increase back and waist pain, it is necessary not to lie face down. Using too many pillows while sleeping is also not recommended.

Scoliosis Treatment

Scoliosis treatment; It is planned by taking into account the age of the patients, the degree and location of the curvature, the severity of pain in adults, the findings of physical examination and imaging methods, the increase in the degree of curvature over time, and personalized. Early diagnosis, thanks to scoliosis x-ray and examination, greatly increases the success of scoliosis treatment.

In the treatment of scoliosis, observation, corset treatment, physical therapy and surgical operation are applied. Observation, which is the first option of treatment, is usually applied for curves below 20 degrees and shows how much the curve increases over time. Scoliosis physical therapy applications and surgical operation are especially suitable for adults and more severe cases. However, surgical operations are the last resort for the treatment of scoliosis in both children and adults.

Which Doctor and Department to Go to for Scoliosis?

It is necessary to apply to the Orthopedics department for the diagnosis and treatment of scoliosis.

Corset Treatment for Scoliosis Patients

Scoliosis brace is used to control spinal curvature in the treatment of young children and infants. Brace treatment is one of the effective methods, especially in moderate scoliosis where the curvature is between 20 degrees and 40 degrees. In some cases, it is appropriate to use a corset up to 60 degrees in children whose bone development continues. Although this method does not correct the curvature, it stops its progression. Corsets are changed as children get older.

What Happens If Scoliosis Is Not Treated?

As with all other diseases, scoliosis can cause different health problems if left untreated. Especially in cases where the curvature is not controlled and continues to progress, the rib cage narrows and patients have difficulty in breathing. Appropriate treatment is essential to prevent problems such as shortness of breath in developing children.

However, in mild scoliosis, treatment is not needed unless a serious health problem is observed. Patients go to check-ups at regular intervals only to understand whether the spinal curvature has progressed.

Scoliosis Surgery

If the progression of the curvature cannot be stopped by non-surgical methods and the symptoms continue, scoliosis surgery is performed. For this reason, those with advanced spinal curvature are doing research on what is scoliosis surgery. Surgery is the right treatment method for those who complain of symptoms such as severe pain, problems in bowel functions and loss of strength in the muscles.

Spine stabilizing operations are usually performed in adults who have completed their development. spinal fusion; It is the process of using metal rods, wires and screws, as well as bones taken from a part of the body of the patients, to correct the curvature of the spine. Fusion surgery is not recommended, especially in children under the age of 10. Specially produced rods are used to stop the curvature in these children. This surgery, which does not adversely affect lung development, is repeated as children grow and the rods are lengthened.

The recovery period after scoliosis surgery takes longer than other operations. The patients, who are kept under surveillance for the first week, can return to their daily life within 1 month, and can engage in sports activities from the 3rd month.

How Many Hours Does Scoliosis Surgery Take?

Scoliosis surgery, which is one of the long and difficult operations of orthopedic surgery, takes 3-4 hours on average.

Are There Risks of Scoliosis Surgery?

Like any surgery, scoliosis surgery has some risks. The risks of scoliosis surgery include bleeding, clot formation, infection in the wound areas, incomplete placement of the prostheses, and damage to the spinal nerves. Nerve damage causing paralysis and numbness in the legs and problems with bowel function are rare risks. Wound infections are cured with the use of antibiotics. If the metal rods or screws are not placed properly, patients usually undergo reoperation.

How Should Scoliosis Exercises Be Done?

People with spinal curvature often research whether scoliosis can be corrected with exercise. Although there is no scientific research on the effectiveness of back exercises in the treatment of scoliosis, it is recommended to perform scoliosis movements by most specialist doctors. The main purpose of scoliosis exercise applications is to increase muscle strength and reduce back pain. Depending on the age group and the degree of scoliosis, the movements determined by the specialist doctors can be done.

Age is a very important point in determining the exercise time. Very young children may not want to exercise regularly and stop exercising during the main developmental period. For this reason, care should be taken when planning the exercise time of young children.

How should patients with scoliosis lie down?

Scoliosis patients are generally recommended to lie on their back. One of the most important reasons for sleeping this way is to put an equal load on the spine. In this way, the progression of spinal curvature can be prevented. Scoliosis patients can sleep on their back as well as on their side. Bending the legs in this position and placing a support such as a pillow under the knee is also good for the patients. Lying face down is not recommended as it causes the back to straighten. Beds should be medium hard or firm. Those who have scoliosis surgery use products such as supportive splints to protect their back areas after the operation.

How should scoliosis patients be fed?

Scoliosis is generally not related to nutrition. However, in order to prevent the progression of the curvature or to maintain a healthy life, it is necessary to eat a balanced diet and exercise regularly.

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