• 25 FEB 18
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    Spinal Problems – Scoliosis

    Adolescent Idiopathic Scoliosis

    This frequent type of scoliosis is most commonly seen in age group 10-18 and is more frequent in girls. The reason for the scoliosis, where early diagnosis is essential, is not fully known.
    Spine is straight from the front and the back. However in case of scoliosis the spine is curved to the left or right. Seen at a frequency of 2% to 4%, scoliosis generally manifests in adolescence. Therefore it is highly beneficial to visit a paediatric orthopaedist for examination at ages 10 to 12 for girls and 13 to 14 for boys, even in lack of any complaint.

    How is scoliosis detected?

    Scoliosis can manifest at any age. However the most frequent type of scoliosis is called “idiopathic”. It is named thus because its reason is not completely known. About 2% to 3% of the adolescents have 10- to 20 degrees curve in the spine. 0.3% have curves exceeding 30 degrees. This degree cannot be ignored. Therefore families with adolescent children shall observe their children carefully. Family shall consult a doctor if;

    • Two shoulders are at different levels,
    • If two legs are of different lengths,
    • One of the hipbones is higher and other is lower,
    • Stepping and posture of feet are different,
    • Ribs of one breast is at the front or the back compared to the other,
    • If one of the shoulder bones becomes visible.

    Apart from these, there’s a belief in the society that carrying heavy backpack causes scoliosis. This is not true. If a child has scoliosis, carrying heavy backpacks only accelerate the progression of the disease. However, if the spine of the child has no curves, carrying heavy backpacks do not cause scoliosis.

    Early diagnosis is important

    Examination findings are important in diagnosis of scoliosis. Final diagnosis is made with x-ray. Most scoliosis cases do not require MRI. MRI is required in case the child has both scoliosis and kyphosis, in presence of another disease related to skeletal system or in case of diseases related to the neural system (brain and medulla).

    Is operation necessary?

    Each scoliosis case does not require surgery. The degree of the curve in the spine is checked.

    • Patient is observed in curves between 10 and 20 degrees.
    • If the curve is between 25 and 45 degrees and the increase in length has not slowed in the child, corset treatment is used. Measuring the body of the child and prescribing suitable corset is important in corset treatment. Child shall wear this corset for 20 to 22 hours a day until skeletal growth is completed.
    • Surgery is necessary in curves beyond 45 degrees. Scoliosis surgery is beneficial and necessary to correct the curve and prevent its increase in the adolescence, where the child rapidly grows.

    Patient must be hospitalized for 5 days after the operation. Patient shall be walked with assistance from the day of the operation. In three weeks the patient can start walking without assistance.

    Scoliosis Types and Treatment Processes

    There are other scoliosis types seen in the society, apart from the scoliosis seen in adolescence.

    Neuromuscular Scoliosis

    Second most frequent scoliosis type. There’s an underlying neuro-muscular disease in this type. Cerebral palsy, polio, meningomyelocele (Spina bifida) are examples of such diseases.

    Congenital Scoliosis

    Scoliosis detected during birth or even during pregnancy. Mother using alcohol during pregnancy and mother having diabetes increases risk. It is seen together with many congenital anomalies. Its treatment differs widely from idiopathic scoliosis. Today, magnetic, extending rod systems are used in surgeries. These rods are extended without operation or pain using remote control in clinical condition every 2 or 3 months. Thus increased height of the child poses no problem.

    Degenerative Scoliosis

    These are scoliosis not detected during adolescence manifesting in ages 40 or 50. Surgery is necessary for definitive treatment. Surgery corrects the curvature and problematic spines are immobilized with a process called fission

    Early Onset Scoliosis

    It is seen in age range of 4-10. It is detected earlier. More frequent in girls. It manifests at these ages with syndromes affecting the brain and medulla. Follow-up and treatment is similar to congenital scoliosis.

    Infantile Idiopathic Scoliosis

    It’s a rare scoliosis type not present at birth but manifesting around the age of 4 and seen more in boys. It manifests with brain and medulla problems.

     

    Contents of the page are for information purposes only, you must consult your doctor for diagnosis and treatment.