Its short definition is the curvature of the spine. This is a deformity with rotation in the axial axis, not just lateral curvatures when viewed in the foreground. It can occur at any age from birth to the end of the growing age.

 

A classification can be made according to the period in which the curvature appears. Infantile idiopathic scoliosis; It is seen between the ages of 0-5. It is more common in men. Juvenile idiopathic scoliosis; It occurs between the ages of 3-10. The male-female ratio is equal. It is often progressive. adolescent scoliosis; It occurs between the age of 10 and the completion of skeletal growth. It is more common in girls. Most of the scoliosis is in the group called idiopathic, the cause of which we do not know yet. It is also seen in congenital spine and rib anomalies and neuromuscular diseases. Scoliosis, which is seen at an average rate of 2-4% in our country, is approximately 10 times more common in girls.

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At low degrees, it can be difficult to notice the asymmetry in the body. Especially while taking a bath, parents should be alert for symptoms such as protrusions in the shoulders, chest and back. When children with scoliosis are viewed from behind, it can be seen that the spine is not in a straight course, and the head and pelvis are not in line. Due to the rotation of the spine, the thorax remains inverted on one side; It is noticed that the ribs rise unilaterally on the back and a hump (rib-hump deformity) develops. This protrusion becomes more pronounced when the child leans forward. Depending on the type of scoliosis, one shoulder is sometimes lower than the other. Back, chest, and abdominal pain are rare. In advanced scoliosis, respiratory-circulatory symptoms such as heart ve respiratory distress due to decreased lung capacity, burping, quick fatigue may occur. Evaluation and follow-up of scoliosis is done with radiographs covering the whole body (including the neck and pelvis). Curvature is measured in degrees by a method called the Cobb method.

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It should not be forgotten that scoliosis starts at a young age, has double curvature, is a male patient, and large and unbalanced curvatures increase rapidly. It is observed that the increase in curvatures accelerates with the appearance of secondary sex characteristics during puberty. Progression of the scoliosis curvature is considered an increase of 5 degrees or more within 6 months. Treatment is planned by considering these conditions, the type and degree of scoliosis.

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No corset or surgical treatment is applied for curves below 20 degrees. Exercises are given to strengthen the posture and trunk muscles. The patient is followed up at 6-month intervals. If there is no increase in the curvature, the treatment is continued with this treatment program. The corset method is used for curves that do not progress rapidly, flexible, up to 40 degrees in the back region and 30 degrees in the waist shade. The corset is custom made. The aim is primarily to stop the progression of the curvature. Sometimes, albeit limited, improvement is achieved. It is recommended to use 22-23 hours a day. Surgical treatment is chosen for scoliosis that is 40 degrees and above in the back, 30 degrees and above in the lumbar region or rapidly progressing scoliosis. For surgical treatment, it should be determined that the childs bone growth has ended. Earlier surgical procedures may lead to short stature or new unpredictable deformities. Because the procedure is a process that requires bony union between the vertebrae and results in this way. For this reason, in children younger than 10 years of age, this procedure is very limited or is done using temporary lengthening rods.

 

With the development of anesthetic drugs, imaging methods and intraoperative neuromonitor applications in recent years, surgical complications have decreased significantly.

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