There are a total of 33 vertebrae in the spine in five major regions; neck (5), back (12), waist (5), sacrum (5) and coccyx (4). Intervertebral discs are located between two neighboring vertebras in order to enable our spine bear the load of your body and move our body forward, backward and both sides.
While the spine has physiological curvatures on the anterior-posterior plane, it extends straight from the neck to the coccyx on the vertical plane.
The reduction or increase of these physiological curvatures and spine’s rotation or curving to sideways brings are accompanied by many problems.
The goal of the spinal surgery is to relieve the pain caused by abnormal curvatures and to correct kyphosis and abnormal body posture to relieve the pain, treat joint problems caused by postural disturbance, and manage other neurological symptoms that may even involve fainting in advanced stage diseases.
Abnormalities that may occur in the spine can be congenital or may be acquired due to causes such as, deformation and improper body posture while working.
Scoliosis is most common abnormal curvature of the spine. Scoliosis refers deformity of the spine.
Scoliosis implies a condition where the spine curves sideways at dorsal and lumbar level and it occurs more commonly in girls during rapid increase of body height.
On lateral view of normal human anatomy, some curvatures can be seen in the spine. For example, dorsal spine curves back, while cervical and lumbar spines curves front. However, the spine appears straight on the antero-posterior plane. Scoliosis refers a “S” or “C” configuration of the spine on this plane accompanied by abnormal rotation. Shoulder asymmetry, dorsal hump, abnormal body posture and lumbar curvature asymmetry can be seen in patients with scoliosis due to the abnormal curvature.
Forward bend test is used to diagnose the condition. If the test yields suspicious results, the person is asked to clench hands, bend forward and keep hands between knees. Meanwhile, the doctor stands behind the patient to check whether there is an asymmetry in the dorsal spine. If asymmetry is identified, scoliosis is considered. However, you will need to see a spine surgeon who is specialized in this condition.
Shoulder asymmetry, dorsal hump and asymmetry of lumbar curvature may be the symptoms of scoliosis.
Scoliosis has many underlying causes. For congenital cases, the problem might arise out of development or separation of vertebrae. Muscle disorders or nervous diseases, such as cerebral palsy, may play a role in neuromuscular cases. However, the condition is most commonly idiopathic or in other words, there is no clear underlying cause. This type is usually diagnosed in early adolescent girls. Genetic and environmental factors have been claimed.
Your spine surgeon may take measures to stop the progression.
There is no clear evidence that lifting heavy objects or hunching the back leads to scoliosis. However, pains originating from the spine can be prevented, if you work in good body posture while working with computer or studying lessons.
Do not worry; scoliosis is a treatable condition. You should necessarily see a spine surgeon as soon as possible.
There is no sports limitation. Swimming, volleyball, basketball and pilates are more commonly recommended as they exercise back muscles and help body balance and control.
Treatment is planned according to angle of curvature, age of the patient and developmental level of the body. For narrow angles and early stage cases, your doctor will offer options of corset and exercise along with regular follow-up. However, efficacy of these treatment methods has not scientifically been proven. Therefore, the curvature may progress. For advanced stage curvatures (angle >45°), surgical treatment is recommended. Screws are driven to vertebra and they are connected to each other using rods. Although spine surgeries are high-risk operations, the risk can be minimized if surgeries are carried out by specialized surgeons. Moreover, advanced technology provides surgeons with substantial means. Now, we use 3D printing technology in order to drive screws at accurate positions and to prevent damage to the nearby vital tissues (spinal cord, arteries, lungs etc.) in spinal surgeries.
Postoperative care varies for each type of scoliosis, but absorbable stitches are used for idiopathic scoliosis, the most common type. Patient controlled analgesia is maintained for 2 days to manage the pain. If no complication occurs, patients are discharged 3 to 4 days after the surgery in average. Patients allowed taking a bath 10 days later. Patients can start going to school 3 weeks later in average. Patients usually do not need corset after the surgery.
All surgeries are performed with micro-surgical methods under microscopic visualization and recently, endoscopic methods are used; in this discipline, training and expertise of surgeons are as important as the availability of technical equipment.
At Medicana Hospitals, Neurosurgeons, Neurologists and Physiatrists cooperate in the field of Spine Surgery.
Minimally Invasive Surgical Interventions
Micro-surgical treatment of Cervical, Thoracic and Lumbar Disc Hernia
Surgical Treatment of Stenotic Spinal Canal
Fully Endoscopic Management of Pain
Spinal Cord Tumors
Surgical Treatment of Head and Spine Traumas
Cerebral Tumor Surgery (Adult and Pediatric)
Endoscopic Pituitary Gland Surgeries
It is really important that the postoperative patients or patients, who are planned to undergo operation, are assessed with respect to various therapy and follow-up options.
Minimally invasive procedures may shorten hospital stay. Hospital stay varies depending on the condition of the patient and the procedure, but spinal surgery patients are usually discharged to home within 2 to 3 days.
It is believed that minimally invasive procedures cause less postoperative pain than conventional methods, while muscles and soft tissues are untouched. Recently, modern pain management modalities make management and relief of pain easier.
Your doctor may recommend physiotherapy to accelerate recovery and strengthening. This will depend on the procedure and your overall physical condition. Special exercises will help you to be strong enough to engage in work and daily life activities.
You will be educated on correct body posture while sitting, standing and walking.
Time required to start doing daily life activities after the surgery varies depending on the surgical procedure and your condition. Your doctor will postoperatively assess you to ensure that recovery proceeds as expected.