Treatment of scoliosis, which is an abnormal deviation of the spine that affects both adults and children, is carried out through several methods that differ from person to person according to the age of the person and the severity of the condition.
Lateral scoliosis, scoliosis, or what is called Scoliosis, is a case of abnormal curvature, curvature, or lateral torsion in the form of the letter “S”, whether to the left or the right, and it differs from the condition called kyphosis, in which the spine bends forward.
The normal spine has forward and backward curvatures in the cervical, thoracic and lumbar regions. These natural curvatures place the head above the pelvis, and act as a shock absorber to distribute mechanical stress during movement.
But in scoliosis, the spine rotates around itself, causing a curvature and scoliosis from one side to the other, and the degree of this curvature may be 10 degrees as in mild cases, and it may reach 100 degrees or more in severe cases. Because of this curvature may be associated with concavity or Rib cage bulging
Scoliosis affects people of all ages in general, but it is most common between the ages of 10-15 years, and although it is rare in newborns, it may affect infants before the age of three.
The treatment of scoliosis aims to relieve the patient, reduce back pain and remove symptoms. The treatment of scoliosis does not necessarily depend on repairing the curvature. The main goal here is to relieve pain and improve function and movement of the back.
Causes of curvature of the spine
Most cases of scoliosis are from unknown causes, and they cannot be avoided, but there are other causes such as:
- Congenital scoliosis: results from the fetal malformation of one or more of the vertebrae of the spine, and may occur at any site.
- Neuromuscular conditions: These conditions affect the nervous system and muscles, including cerebral palsy, poliomyelitis, and muscular dystrophy.
- Certain genes: Heredity plays a role in scoliosis sometimes.
- Leg length: When one leg is taller than the other, a person may develop scoliosis.
- Osteoporosis: Osteoporosis may cause secondary scoliosis due to degeneration of the bone associated with Osteoporosis.
- Other causes: such as standing incorrectly, carrying backpacks, connective tissue diseases, and some injuries that may cause a twisted spine.
For different reasons, treatment methods for scoliosis differ.
Factors that increase the risk of developing scoliosis include genetics, since the patient usually has close relatives with the same condition, and age, when scoliosis symptoms often appear during the growth spurt of prepubescent adolescents.
It should be noted that females are more susceptible than males to scoliosis.
Types of scoliosis
There are seven main types of scoliosis:
- Congenital scoliosis
- Early onset scoliosis
- Scoliosis of unknown cause
- degenerative scoliosis
- Neuromuscular scoliosis
- "Schuerman" hump
- Syndromic Scoliosis
There is another classification of scoliosis based on the position of the curvature in the spine, which is illustrated by the following picture:
Symptoms of scoliosis
Symptoms of scoliosis appear in childhood or in adulthood, and symptoms vary according to the age of the affected person.
Symptoms in adults
There are several signs that may indicate scoliosis. If you notice one or more of them, you should go to the doctor to start diagnosing and treating scoliosis:
- One shoulder may be higher than the other, and shoulder blades may protrude.
- Hip elevation from one or both sides.
- head is not located above the center of the body or the pelvis.
- The ribs protrude outward on one side
- Visible curvature of the spine
- asymmetric waist
- Slight difference in the lengths of the lower extremities
- Back ache
Symptoms in young children
Symptoms include a bump on one side of the chest, and the body is constantly deviating to one side while lying down. In some severe cases, problems with the heart and lungs occur, leading to difficulty breathing and chest pain.
If the infant does not receive treatment for scoliosis, he will be at risk of greater problems later in his life, such as impaired heart and lung function, so treatment is especially important at this stage of life.
Spinal curvature diagnosis
The doctor performs a clinical and physical examination of the spine, shoulders, ribs and hips, and examines the shape of the back and movement of the patient, and the nerves are also examined through reflexes, sensations and muscle strength tests.
Using special devices to examine scoliosis, the doctor measures the degree of curvature angle, if the angle is greater than 10 degrees, this indicates the presence of scoliosis.
The doctor may order a back x-ray, computed tomography, and magnetic resonance imaging, as these tests help him estimate the shape, direction, location and angle of the curvature.
After confirming the diagnosis, a referral is made to an orthopedic doctor to discuss the condition and start treating scoliosis.
Spinal curvature treatment in Turkey
The treatment of scoliosis may be surgical or non-surgical, and the method of treatment varies depending on the type of scoliosis in the patient and his age when the disease developed.
Most cases of scoliosis in children and adults are usually mild and do not require treatment, but if the angle of curvature is from 10 to 25 degrees, the patient is monitored and examinations are carried out at intervals to see if the disease is developing.
If the angle is between 25 to 40 degrees, the doctor may suggest treatment by placing a special belt to correct the deviation, but if the angle is greater than 40, and the skeleton is immature, the doctor may recommend surgical treatment.
Here are the main treatment methods:
Treatment of scoliosis by splinting
This method is adopted to treat infants, where the splint is used instead of fixing the curvature of the spine with a brace, and return it to the normal position, as parents prefer that the infant wear a permanent splint instead of a removable belt when the child is young.
the treatment involves the infant wearing a splint device around his back permanently without removing it, but it must be changed every few months as the infant at this age is in a period of continuous growth.
Treatment of scoliosis by means of the belt
The supportive belt or corset, or the so-called (medical corset) is used in moderate cases of spinal sprains, in those who have not stopped growing, as the belt loses its usefulness when the bone growth stops, although the belt will not fix the deviation of the spine, but it will prevent the condition From progression to worse in 75% patients.
The patient wears the belt at all times, even during bedtime, as the effectiveness of the belt is proportional to the number of hours the patient wears it per day, and the number of hours of wearing it may reach 22 or 23 hours per day with its removal for reasons of cleaning and exercise.
There are many different types of belts, and the choice is made according to the number of sprains and their location in the vertebrae and column, and it is designed in the appropriate size for the child, some types provide support at the pelvis, front and back of the head, and some provide support along the torso and lower arms.
Most types of belts are hard and stiff but there are other types that have been developed where they are more flexible.
When the bone growth stops and the child reaches skeletal maturity, the stage of weaning from the treatment of scoliosis begins, as the hours of wearing the belt per day gradually decrease over a period of six months to a year, allowing the patient’s back and trunk supporting muscles to become stronger after the period of inactivity that has passed by the patient.
Physical therapy and exercise are also recommended, both during treatment with the belt or during weaning from it.
Treatment of scoliosis by surgery
the doctor resorts to treatment by surgery if other methods of treating spinal deviation fail to stop the progression of the curvature of the spine, or if the curvature of the spine develops to more than 50 degrees, whether the treatment is done using the belt or not, which requires surgical intervention on the back to solve the problem.
Surgery in children
Spinal curvature and scoliosis repair surgery is performed in children younger than 10 years old, by inserting special sticks parallel to the spine, which stops the progression of the curvature of the spine for the worse.
After the surgery in order to treat scoliosis, the patient visits the doctor every few months to lengthen the sticks in proportion to the growth of the child, and this is done in two ways, either through a simple surgical procedure where the sticks are lengthened through a small incision in the skin through the back.
Or by using a control device that activates a magnet inside the sticks and lengthens them without the need for a surgical incision, and after the growth stops, these sticks are removed and a final operation is performed to correct and correct the deviation of the spine.
But even if the scoliosis is treated with surgery, the child still needs to wear a corset or belt to protect the back from harm.
Surgery in adolescents and young adults
Surgery for scoliosis in adolescents and adults who have stunted growth is called spinal fusion surgery to correct the misalignment of the spine.
It is a major surgery, in which the spine is straightened by using metal rods, screws and wires, in addition to cutting bone taken from other areas of the body, such as the hip.
Read more about: Lumbar spine fixation surgery to straighten the back.
It is also recommended to wear a belt after surgery to protect the back until a complete and natural recovery is reached without any problem or injury.
What are the risks of surgery?
Like any surgical intervention, there is a risk of complications, and the doctor does not perform surgery unless the benefits outweigh the risks. The risks may include bleeding that may require a blood transfusion if it is severe.
The wound may also become infected, which is usually treated with antibiotics, and metal rods may fail to stabalise well, which requires another surgery.
Rarely, the spinal cord nerves may be damaged, causing permanent numbness in the legs, or may cause paralysis of the lower extremities and loss of bladder and bowel hold.
If the patient with scoliosis is left untreated, this will lead to serious health problems in the long term, especially curves with a degree greater than 50, where the lung capacity may decrease significantly and serious heart problems may occur.
Sports that involve excessive curvature of the spine or increase its curvature beyond its normal limits, such as gymnastics and diving, should be avoided.
Walking is a healthy and safe exercise for scoliosis, as it does not involve using one part of the body more than the other or increasing pressure on the spine.
The doctor may advise taking vitamin D3, which helps increase bone density, and supplements containing magnesium, which maintains the health of the spine, and may also prescribe fish oil, due to its anti-inflammatory properties.