Scoliosis

Scoliosis is a condition characterized by the abnormal curvature of the spine. Unlike the natural front-to-back curvature, scoliosis involves a lateral deviation. In its early stages, it may be mild and remain asymptomatic. The disorder is most commonly diagnosed during adolescence. At this stage, management options may include physical therapy, bracing, or surgical intervention depending on the severity of the curve.

What is Scoliosis?

Scoliosis, deformities and lateral curvatures in the waist and chest regions of the spine. 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.

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 Grades

Definition and Threshold

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 and below are considered spinal asymmetry, not scoliosis.

Mild Scoliosis

Mild scoliosis refers to a curvature less than 20 degrees. A 20-degree scoliosis image usually indicates that no treatment is needed. However, patients should attend regular check-ups to monitor whether the curvature increases.

Moderate Scoliosis

Curvatures between 20 and 40 degrees are classified as 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.

Severe Scoliosis

Severe scoliosis is defined as curvature over 40 degrees. Since 40-degree scoliosis and above cause significant symptoms, most patients in this group are treated with surgery.

How is Scoliosis Grade Calculated?

Imaging methods do scoliosis grading. Computed tomography, radiography, and MRI are the methods used in grade calculations.

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.

How is Scoliosis Diagnosed?

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.

Physical Examination in Adults

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.

Use of Imaging Methods

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.

Role of MRI

MRI is generally used in patients with symptoms such as pain in the leg and back regions and intestinal problems.

Role of CT Scans

In scoliosis with curvatures greater than 40 degrees, computed tomography is required to better see the bone and spine.

Scoliosis Treatment

Scoliosis treatment is planned by considering the patient’s age, the degree and location of the curvature, the severity of pain in adults, findings from physical examinations and imaging, and how much the curvature progresses over time. Early diagnosis with scoliosis x-rays and examinations significantly increases treatment success.

Treatment options include observation, corset treatment, physical therapy, and surgery. Observation is generally used for curves below 20 degrees and helps track progression. Physical therapy and surgery are more suitable for adults and severe cases. Surgery is considered the last option in both children and adults.

Corset Treatment

Bracing is used to control spinal curvature in children and infants. It is especially effective in moderate scoliosis between 20 and 40 degrees. In children whose bone development continues, braces may be used up to 60 degrees. While bracing does not correct curvature, it prevents further progression. As children grow, braces are replaced with new ones.

Scoliosis Surgery

When non-surgical methods fail to stop progression and symptoms persist, surgery becomes necessary. It is the main option for patients with severe pain, bowel problems, or muscle weakness.

In adults who have completed development, spinal fusion surgery is common. This involves using metal rods, screws, and sometimes bone grafts to correct the curvature. In children under 10, fusion is avoided. Instead, special rods are placed to control curvature without affecting lung development. These rods are lengthened as the child grows.

Recovery from scoliosis surgery takes longer than many other operations. Patients are monitored for about a week, can return to daily life within one month, and resume sports after three months.

What Scoliosis Patients Should Not Do

• Avoid cumbersome exercises: While regular exercise is beneficial, heavy or overly demanding workouts should be avoided.
• Choose supportive activities: Swimming, yoga, and Pilates are recommended as they strengthen back muscles, reduce pain, and improve mobility.
• Refrain from high-impact sports: Long-distance running, horseback riding, and other activities that put pressure on the spine should be avoided.
• Post-surgery restrictions: Patients who have undergone scoliosis surgery should stay away from multi-contact sports that may cause trauma.
• Limit prolonged desk work: Sitting for long hours at a desk can worsen spinal curvature and should be minimized.
• Avoid lying face down: This position can increase back and waist pain.
• Do not use too many pillows: Excessive pillow use while sleeping is not recommended, as it may affect spinal alignment.

Frequently Asked Questions About Scoliosis

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 breathing. Appropriate treatment is essential to prevent problems such as shortness of breath in developing children.

However, treatment is not needed for mild scoliosis unless a severe health problem is present. Patients go for check-ups at regular intervals only to determine whether the spinal curvature has progressed.

How many hours does scoliosis surgery take?

Scoliosis surgery, one of the long and complex operations of orthopedic surgery, takes an average of 3-4 hours.

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 appropriately placed, 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 treating scoliosis, most specialist doctors recommend performing scoliosis movements. Scoliosis exercise applications mainly aim to increase muscle strength and reduce back pain. Depending on the age group and the degree of scoliosis, specialist doctors can determine the movements.
Age is a critical point in determining exercise time. Very young children may only want to exercise occasionally 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 rest 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 suitable for the patients. Lying face down is not recommended as it causes the back to straighten. Beds should be medium hard or firm. Those with scoliosis surgery use products such as supportive splints to protect their back areas after the operation.

How should scoliosis patients be fed?

Although scoliosis is generally unrelated to nutrition, eating a balanced diet and exercising regularly can prevent curvature progression and maintain health.

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.

Which doctor and department to go to for scoliosis?

It is necessary to apply to the Orthopedics department to diagnose and treat scoliosis.

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.