Spine Health, Orthopedics and Traumatology Specialist Prof. Dr. Ahmet Alanay “Spine curvature occurs most frequently in adolescence. As the growth continues, the curvatures continue to progress. Especially during adolescence growth spurt, when mild and moderate curvatures reach moderate and advanced levels within 2-3 months, treatment can become difficult and fusion surgery is the only solution.
Families who hesitate to go to the hospital due to pandemic conditions may prefer to wait, since scoliosis usually does not cause pain. However, the elapsed time may cause the curvature of the spine to progress and the golden window to be closed for non-surgical or surgical treatments that preserve movement. For this reason, it is important to get expert opinion as soon as scoliosis is suspected, and to diagnose and treat progressive scoliosis early. Early diagnosis is important because small and moderate scoliosis can be stopped with bracing, exercise and surgical treatments that preserve motion without fusion.
Early diagnosis does not help in scoliosis: FALSE
TRUTH: This idea developed based on the belief that the brace failed, which is no longer valid, and that the only treatment is fusion surgery (fixing the vertebrae with screws and rods and eliminating movement and growth in this region). However, data in recent years have shown that curvatures can be controlled with early non-operative treatments (corset and scoliosis-specific physical therapy exercises). In addition, non-fusion spine surgery (tape stretching; vertebral body tethering, VBT) is becoming increasingly common. The success of the band stretching technique depends on the appropriate patient selection and application at the ideal time. For all these reasons, the importance of early diagnosis is increasing day by day. Early diagnosis allows for more physiological treatment methods.
Some sports cause scoliosis, some prevent scoliosis: FALSE
FACT: There is no data showing that engaging in any sport at the hobby level or professionally increases the frequency of scoliosis. Similarly, there is insufficient evidence that increasing muscle strength by engaging in sports activities prevents the formation or progression of scoliosis or improves scoliosis. But strengthening the posture muscles is good for spine health in general. In addition, there are scientific data that scoliosis-specific physical therapy exercises, especially together with a corset, can be effective.
Scoliosis is a painful disease: FALSE
FACT: Mild to moderate scoliosis curves do not cause pain. The most common cause of spinal pain in individuals with straight or curved spine alignment is muscle fatigue pain, which is expressed as mechanical pain and occurs due to muscle strength weakness. If the degree of scoliosis progresses significantly, it can cause pain. However, not all back pain does not mean that scoliosis progresses. Similarly, pain may occur when individuals with scoliosis reach adulthood and when signs of curvature and age-related calcification appear.
Corset treatment does not work in scoliosis: FALSE
FACT: The corset is still a product made by hand and mastery. Today, there are many corset designs with different mechanisms of action. For this reason, there have been articles in the past years that have published conflicting results about the success of the corset. However, in a more recent study supported by the American and Canadian Ministries of Health, the effectiveness of corset treatment has been definitively demonstrated. The most successful range of corset treatment is curvatures between 20 and 45 degrees. The most important effect of the corset is that it significantly reduces the rate of going to surgery. Apart from this, the most basic benefit expected from the corset is the prevention of the progression of the curvature. Less frequently, a decrease in the direction of improvement in curvatures can be seen.
Individuals who have had scoliosis surgery cannot exercise: WRONG
FACT: Modern instrumentation techniques and implants provide fusion at the surgical site. For this reason, individuals who have undergone fusion surgery can do sports after the union of the bones and screws is completed. Although all kinds of sports can be performed, including extreme sports, the appropriate sports to be performed after fusion surgery may vary according to the level of the surgery. The band stretching method is a non-fusion procedure, and since bone union is not expected, all kinds of sportive activities can be performed from the early period after the operation.
Poor posture causes scoliosis: FALSE
TRUTH: There is not enough scientific evidence that poor posture, sitting in inappropriate positions and carrying a heavy school bag have an effect on scoliosis initiation. However, conditions that cause unsymmetrical load distribution in the spine may pave the way for the progression of scoliosis that has once appeared and started. Regardless of the existence, formation and progression of scoliosis, staying in bad posture for a long time, sitting incorrectly and carrying heavy loads asymmetrically are also harmful for spinal health in general.
The frequency of scoliosis has been increasing in recent years: FALSE
FACT: Over the years, especially thanks to social media, awareness of scoliosis has increased and this has created a perception as if the frequency of scoliosis has increased. However, the incidence of scoliosis is similar in different parts of the world and has not changed in recent years. It occurs in about 3 percent of the world. Current studies conducted in our country and abroad also point to similar rates. The increase in social awareness about scoliosis has increased the early diagnosis and thus the success in treatment.
Scoliosis is a genetic condition passed from parent to child: FALSE
FACT: Genetic or inherited diseases are passed from parents to the next generation via chromosomes and DNA. This term for scoliosis is not entirely correct. Studies conducted on identical twins with exactly the same genetic makeup have shown that if one twin has scoliosis, the probability of having scoliosis in the other twin is around 70 percent. This situation reveals the importance of environmental factors as well as genetic factors in the development of scoliosis. When all the data are evaluated together, it is seen that most of the scoliosis of unknown cause occurred coincidentally rather than being hereditary.
Surgical treatment in scoliosis cannot be performed until the age of 18-20: FALSE
FACT: There is a surgical treatment for scoliosis suitable for all ages. Non-surgical children are primarily selected for growing children, but these methods are not always successful. In such cases, if the growth is expected to end, the curvatures may worsen to very advanced degrees and the surgeries may become more difficult and risky. Therefore, in cases where there is no response to non-surgical treatment, curvatures are controlled by the application of surgical treatments that do not stop growth, support (growing rods) or direct growth (tape stretching; vertebral body tethering, VBT).
Individuals with scoliosis cannot become pregnant and give birth: FALSE
FACT: Individuals with scoliosis can have as many pregnancies as they want, regardless of the type of treatment (surgical or non-surgical), and they can have children both by normal delivery and by cesarean section. Individuals with scoliosis should consult their doctor before becoming pregnant if lung and heart problems have started in untreated or late treated very advanced curves.
Check your child from time to time
prof. Dr. Ahmet Alanay stated that parents should check their children in the rapid growth period frequently and said, “There are clinical findings such as shoulder and waist asymmetry in scoliosis, swelling on the back or one side of the waist when bending forward. Although the cause of scoliosis is unknown, the biomechanical foundations of how scoliosis progresses have been elucidated. For this reason, it is useful to check the children from time to time. If there is a suspicious situation, it is absolutely necessary to consult the doctor without wasting time,” he says.