WHAT IS THE SCOLIOSIS?
Scoliosis is the most common childhood deformity of the spine. The Human spine is not perfectly straight when viewed from the side. There is a slight depression (lordosis) in the neck and waist region and a slight hump (kyphosis) in the back region.
When the spine is viewed from the back, the vertebrae extend in a straight line from top to bottom in a normal and healthy spine. Scoliosis is a curvature of the spine more than 10 degrees to the side (right or left).
Scoliosis is a symptom, not a disease. It can be congenital, due to various diseases (polio, the diseases with muscle dystrophy, cerebral palsy, etc.), or due to an unknown cause (idiopathic) previously. 75-80% of scoliosis patients are in the idiopathic group. It is most common between the ages of 10-15 and is much more common in girls more than boys.
Figure 1: Scoliosis in lumbar region
WHAT ARE THE SIGNS OF SCOLIOSIS?
- One of the shoulders may be higher than the other one.
- One of the scapulas may be more prominent or higher than the other one.
- With the arms at the side, there may be more space between the arm and the waist on one side.
- One of the hips may appear higher or prominent than the other one.
HOW TO DIAGNOSE THE SCOLIOSIS?
Early determination of scoliosis is very important. The diagnosis is made according to the results of both physical examination and radiological studies. The hump seen in the back or lumbar region when the patient leans forward is an important diagnostic method in which parents’ can check the children’s spine.
HOW TO TREAT SCOLIOSIS?
The treatment is planned individually. The exercise program specific to scoliosis is indispensable at every stage of treatment.
Observation and Follow-up: In spinal asymmetry (less than 10 degrees), also considered the age of the child, whether any progression in the curvature occurred is monitored every 4 or 6 months.
Brace: In moderate scoliosis, the brace treatment is applied in children who not yet completes their growth. The main purpose of brace treatment is to preventthe development of a high-degree scoliosis by preventing its progression rather than correcting the curvature.
Surgery: In high-degree scoliosis, it may be necessary to correct the curvature with surgical treatment.
WHAT IS THE KYPHOSIS (HUNCHBACKNESS)?
When the spine is viewed from the side, the increased curvature in the dorsal region is called kyphosis. The most common type is postural kyphosis. It can occur at any age. Especially in recent years, the intensive use of mobile phones and computers in the childhood and adolescence age group, the increased desk work activity duration has increased the incidence of postural kyphosis. Mild scoliosis may accompany kyphosis in some patients. The most important causes of postural kyphosis are sitting in the wrong position for a long time and weakness of the posture muscles that keep the spine upright. It can mostly improve with exercise and posture training.
WHAT IS THE SCHEUERMANN KYPHOSIS?
A small proportion of patients with kyphosis have a more rigid (immobile) deformity. A sharp angulation occurs in the back in this type of kyphosis which is called Scheuermann Disease. It is seen 2 times more common in males between the ages of 12-17. It is the most common cause of back pain in childhood and adolescence.
Figure 2: Scheuermann Kyphosis
HOW TO DIAGNOSE THE SCHEUERMANN KYPHOSIS?
The kyphosis that becomes evident when the patient leans forward is the most important physical examination finding. However, the definitive diagnosis is made as to the result of radiological evaluations.
HOW TO TREAT THE SCHEUERMANN KYPHOSIS?
Exercise: Although personalized exercise programs are applied, a program that includes exercises to strengthen the back muscles, stretch the anterior side muscles of the chest, stretch the posterior muscles of the legs and strengthen the abdominal muscles is indispensable in patients with kyphosis.
Brace: Brace treatment is applied in the patients whose not growth has not yet been completed. The aim is to prevent the curvature from reaching the level that requires surgery.
Surgery: Surgical treatment may be required in high degree kyphosis.