Scoliosis

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Adolescent Scoliosis

In a normal and healthy spine, when viewed from behind, the spine extends in a straight line from top to bottom. As for in scoliosis, the vertebrae move to the left or right sides and rotate around their own axis at the same time. And in x-ray examinations, in the front and rear view, the spine can be seen in an S or C shape.

The cause of more than 80% of scoliosis cases are idiopathic; so the cause is unknown. Approximately 70% of cases are girls and the disease is progressive. In some cases there is a genetic predisposition.

Early diagnosis and treatment of the disease is what is important for scoliosis. The deformity is progressive in untreated cases. It can cause serious heart and lung problems, by affecting the chest bones.

 

Symptoms

  • One shoulder being higher than the other

  • One leg being shorter than the other

  • One side of the lumbar vertebrae protruding forward 

  • Protrusion of the scapula on one side of the back

  • Low back pain 

  • Unbalanced walking

 

Diagnosis

Scoliosis is diagnosed by evaluating the patient's history, neurological examination, and X-ray and MR results all together. The angle between the vertebrae, which the curvature begins and ends, are measured in the standing anteroposterior and lateral radiographs taken of the entire spine.

 

Treatment Modalities

 

Treatment is determined according to the amount of curvature and which stage bone growth is in. Starting treatment early increases the success rate.

Observation

In patients with curvature below 20 degrees, who are close to completing their skeletal development; observation and regular controls are enough.

 

Conservative Treatment

Surgical treatment is not needed in some of the scoliosis cases of this type.

Those with a small amount of curvature (less than 15-20 degrees) are observed for possible progression. This stage doesn’t require any treatment. Corsets may be needed in those with 20-40 degrees of an angle, because they prevent the progression of the curvature. Even if corsets are uncomfortable for patients, they are important because of their benefits and role in avoiding surgery. Unfortunately, not all scoliosis curvatures respond to a corset. Curves in the cervicothoracic region (the longitudinal section extending from the middle part of the back to the neck) respond to corsets weakly, if they are above 40 degrees. The effect of corsets are limited in patients who have completed their skeletal development.

 

Scoliosis Surgery

 

Surgical treatment is recommended for curvature over 40 degrees. Surgery is also rarely advisable in cases with smaller curvature, which disturbs the patient cosmetically. The goal of surgery is to fix the curvature and prevent the progression of the curvature. Surgery, is performed by placing metal implants to the spine, accompanied with neuromonitorization. Neuromonitorization has further increased the reliability of this process. Neuromonitorization warns the surgeon for nerve injuries during operations and, by so many operations which couldn't be performed before can be done very easily.

After surgery, the patient can easily return to normal activities within 2-3 months.

 

Adult Scoliosis

The definition of adult scoliosis is used for abnormal curvature of the spine occurring in patients over the age of 18. Sometimes untreated curvatures from childhood can show progression and become this type.

Scoliosis is called adult degenerative scoliosis, if there isn't a curvature history from childhood.

It may occur due to osteoporosis and degenerative diseases.

The difference of adult scoliosis from idiopathic scoliosis is that the most common complaint among patients is low back pain. Curvature is usually severe and progressive.

 

Symptoms 

  • Reduction in size

  • Low back pain

  • Weakness, numbness in the legs

  • Shortness of breath, feeling of malaise in severe curvature of the back 

  • One leg being shorter than the other

 

Treatment Modalities

Conservative Treatment 

Conservative treatment is sufficient for most of the patients. Anti-inflammatory medications, physical therapy, epidural steroid injections may be used. Corsets are rarely used. Treatments which include calcium and vitamin D support are given to patients with osteoporosis.

 

Surgical Treatment

Surgical treatment is usually recommended for patients with progressive curvature and to those who do not respond to conservative treatment. The patient returns to his/her normal life approximately 3 months after the operation.

 

Tags: Scoliosis, conditions, back pain

 

 

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SOSYAL MEDYADAN TAKİP EDİN

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@ 2014 Tamer Tekin. Istanbul/Turkey. Tüm hakları saklıdır. YASAL UYARI: YAZILI İZİN OLMADAN KOPYALANAMAZ VE YAYINLANAMAZ.