With the definition of scoliosis, it is expressed that the spine cannot be corrected completely to the side. In parallel with the bending of a tree during its development, the human spine is also open to “external forces” during its developmental phase, which can lead to various bends. However, only one vertebra tilted slightly over the other cannot be described as scoliosis. In the person with scoliosis, the vertebra in the tilted region is rotated right or left over the other vertebra, “that is, turned right or left”. It is found that 3 to 5 out of every 1000 children have curves that require treatment.
What causes scoliosis?
Scoliosis can have a wide variety of causes. Scoliosis may develop due to nerve and muscle diseases. Scoliosis may occur due to metabolic disorders or congenital malformations of the vertebrae and ribs. As a result of the researches, it has been determined that the most observed type of scoliosis is “idiopathic”, that is, a condition that develops spontaneously.
1- Youth skolyoz
It is scoliosis observed between the ages of 4-10. Spinal curvatures of more than 10 degrees are defined as scoliosis. Scoliosis that occurs at this age may have an underlying serious condition such as syringomyelia, tense cord syndrome or a spinal cord tumor. If there is pain, it may not be due to idiopathic scoliosis. Scoliosis curvatures on the left, which we call atypical, should be investigated in terms of another underlying disease.
2- Skolyoz idiopathic adolyoz
Adolescent idiopathic scoliosis is the most common form of scoliosis between the ages of 10-18. This form can be followed in 4 out of every 100 adolescents. Scoliosis above 60 degrees can progress in adulthood. Genetic origins of scoliosis deformity are also being investigated. It is thought that 30 percent of the cases are familial. In this regard, the risk of progression can be revealed by methods such as Scolioscore.
The risk of progression is revealed by scoring between 1-200 with genetic analysis made from saliva. In this regard, SOSORT’s treatment guide published in 2016 or scoliosis progression factor calculation can also be used. In scoliosis progression factor calculation, Cobb is subtracted three times of Risser and divided by chronological age. If this figure is between 1-2, the patient should be followed up every three months with the Schroth exercise method-weighted methods. When it is over 2, corset application should be added to these methods. Risser is calculated by the ossification of the iliac wing. If there is no ossification here, 0 points, if it is completely closed, 5 points are given.
3- Adult spinal deformity
When adult spinal deformity is mentioned, spondylosis, Spinal canal stenosis, spondylolisthesis, rotational subluxation, sagittal plane imbalance (kyphosis / lordosis), scoliosis and rigid deformities come to mind. It is a spinal deformity that occurs with> 10 degrees of shift of the spine from midline to lateral in the coronal plane and> 5 cm deviation from the sagittal vertical axis in the sagittal plane in skeletally mature individuals.
Classification includes primary degenerative (De novo) scoliosis, progressive idiopathic adult scoliosis, secondary metabolic bone diseases, osteoporosis / osteomalacia / paget asymmetric arthritic diseases, vertebral fractures, and secondary diseases such as malignancy, infection ankylosing spondylitis.
When degenerative scoliosis and idiopathic adult scoliosis are compared, it is known that degenerative scoliosis mostly affect the lumbar region and show smaller curvatures and also accompany spinal stenosis at a rate of 84%. In idiopathic adult scoliosis, curves are observed as more advanced curves in the thoracic region, while only 7% of them are accompanied by spinal stenosis.
These lumbar curves are not related to the structural thoracic curve. Compensatory thoracic curves may occur. 10 ° curvatures are observed as 64%, 10–20 °% 44.20 ° and 24%. Pain is one of the most important problems in adults with scoliosis. Schroth exercises, corset and physical therapy methods can be used to control the pain.