What is Scoliosis? How Is Scoliosis Treated?

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  • What is Scoliosis?
  • Types of Scoliosis
  • How is Scoliosis Diagnosed?
  • Does Scoliosis Progress?
  • How Is Scoliosis Treated?

What is Scoliosis?

Our spine consists of vertebrae bones placed on top of each other . Between the bones are discs that absorb shock and allow movement . In this way, the spine can bend and rotate forward, backward and sideways. In this case, scoliosis occurs. So what is scoliosis?

When viewed from the front ; Our spine continues in a straight line between the pelvises and up to our heads, it does not curve to the right or to the left.

In the simplest terms, sideways curvature of the spine is called scoliosis . The spine with scoliosis curves to the right or to the left, and can curve like the letter C or S. Curvatures with an angle of less than 10 degrees are not called scoliosis by definition. Curvatures over 10 degrees are called scoliosis and should be considered for health reasons. The expression “scoliosis” is a symptom, not a disease. There are diseases that cause scoliosis.

In fact , scoliosis is a more complex problem than sideways curvature of the spine . Scoliosis also has a rotational component . In other words , the vertebrae rotate like a screw. Thus, the ribs attached to the vertebral bones are also deformed. A rib hump occurs on one side of the back and the rib cage may narrow. The hump of the ribs in the back becomes more pronounced when the person leans forward.

When viewed from the side, our spine is not in a straight line; It makes a dimple (lordosis) in the waist and neck , and it is slightly curved outward (kyphosis) in the back . When viewed from the side, the increase or decrease of these curvatures can also be a problem. Most commonly, a humpback problem may occur due to the increase in the back arch.

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What Is Scoliosis and What Are Its Types?

Many patients come to physical therapy and rehabilitation clinics with the diagnosis or suspicion of scoliosis. Some types of scoliosis require more strict follow-up than others. One of these is the type of scoliosis called “adolescent idiopathic scoliosis” . Scoliosis is generally examined in two groups.

1. Functional (Non-Structural Scoliosis): The main problem is not in the shape of the spine. A deformity has occurred in the spine for adaptation to a problem in the body . Examples of this are leg length difference, painful conditions such as herniated disc, and posture disorder . If the problem on the floor is resolved, functional scoliosis will also improve.

2. Structural Scoliosis: There is a real curvature of the spine.

  • The cause of structural scoliosis cannot be determined in 80 % of cases. These are called idiopathic scoliosis , meaning “of unknown cause” in medicine .
  • Another condition that causes structural scoliosis is neuromuscular diseases. Muscle weakness occurs in neurological diseases such as cerebral palsy , spina bifida , spinal muscular atrophy . Since the muscles cannot adequately support the spine, a type of structural scoliosis called neuromuscular scoliosis may occur in the later stages of the disease .
  • In addition, congenital developmental abnormalities in the vertebral bones may also cause structural scoliosis. Sometimes , one vertebra may be partially developed or attached to another vertebra at birth. Scoliosis due to this type of bone development disorder is called congenital scoliosis .

The most common cause of scoliosis is idiopathic scoliosis; that is, the cause of which cannot be determined. Idiopathic scoliosis is divided into groups according to the age at which it occurs. Idiopathic scoliosis:

  • Infantile idiopathic scoliosis if it occurs in the first 3 years of age ,
  • Juvenile idiopathic scoliosis if it occurs at the age of 3-9 years ,
  • Adolescent idiopathic scoliosis if it occurs between the ages of 9-16,
  • If it is noticed in adulthood, the term adult idiopathic scoliosis is used.
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Idiopathic scoliosis most commonly occurs between the ages of 9-16 and it is called adolescent idiopathic scoliosis. There is a risk of progression if precautions are not taken.

How is Scoliosis Diagnosed?

Scoliosis may remain undetected for a long time until the curvature progresses . For this reason, it is important to perform a conscious eye examination of the back.

In the examination , besides the anterior and posterior monitoring of the trunk , neurological examination including muscle strength, sensory and reflex examination, measurement of leg length, foot deformity, muscle shortness and joint-connective tissue laxity are evaluated.

In the examination method called the man test , the patient leans forward from the waist and looks from the back to the back to examine whether there is rib hump and right-left asymmetry. A quantitative measurement for asymmetry can be made in this position with a tool called scoliometry.

Research as an X-ray examination called scoliosis is usually sufficient. Scoliosis examination is an X-ray film in which the entire spine, from the neck to the hip, is taken posteriorly, anteriorly and laterally. With this film , parameters such as Cobb angle that defines scoliosis , the beginning, end and peak of the curvature and the degree of maturity of the bones, called Risser staging , can be determined.

Cobb angle is the degree of curvature of scoliosis measured according to a special method. In addition to the Cobb angle, information such as the vertebral bone level that is the most distant from the midline, the bone levels where the curvature begins and ends, the right or left angle of the curvature, whether it is S or C shaped , are used to define the scoliosis in the person.

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You may be interested in: “ How to Measure Scoliosis Angle? 

If scoliosis is due to a congenital bone abnormality, this can be detected with this X-ray. MRI is generally not necessary in scoliosis . However, MRI may be required for atypical curves, if there is a complaint of pain, if there are abnormalities in muscle strength-sensation-reflex examination.

Does Scoliosis Progress?

One of the most important questions when scoliosis is detected in the adolescence period, that is, in the period of rapid height growth and bone development, is whether the scoliosis will progress or not. Some information is useful in this respect:

  • The risk of progression of scoliosis detected in girls is higher.
  • Scoliosis detected at a young age is more risky. The longer it takes for skeletal development to complete, the greater the risk of progression of scoliosis.
  • S-shaped scoliosis with double curvature show a higher rate of progression than C shaped scoliosis with single curvature.

You may be interested in: “ What Should Young People with Scoliosis Do and What Should Not Do? 

How Is Scoliosis Treated?

There are follow-up, exercise, physical therapy, scoliosis brace use and surgery options for the treatment of scoliosis. If scoliosis is caught in the early period, its progression can be stopped by non-surgical methods such as exercise and corset use. In advanced scoliosis, the only therapeutic option may be surgery.

The degree of curvature and risk factors for progression determine which treatment will be applied. As a general framework:

  • Exercise and physical therapy are applied in scoliosis below 20 degrees.
  • Between 20-40 degrees, the use of a scoliosis brace is added to these treatments.
  • In scoliosis over 40 or 50 degrees, the option of surgery comes to the fore.

Keep Reading: “ Scoliosis Exercises That Can Be Practiced At Home ”

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