Scoliosis is a type of spinal malformation caused by bending of parts of the vertebrae (the bones that make up the spine) horizontally. Although this problem, which affects 2 million individuals in Turkey, does not represent a serious issue in general, it can lead to problems in advanced cases, which can have a negative impact on social and daily life. Although it is observed in adults, it is more common in girls during pre-adolescent or adolescence.
What is Idiopathic Scoliosis?
Scoliosis can be caused by a variety of factors. Idiopathic scoliosis is a word used when the cause of the scoliosis is unknown. This word is derived from the Greek words “idios” and “pathos” and meaning “strange, different pain.” It is a medical term that refers to disorders of uncertain origin. It accounts for over 80% of all scoliosis instances, and its advancement can often be halted with early detection and patient follow-up therapy. Furthermore, corset treatment is available in scoliosis patients with curvatures greater than 20 degrees, and surgical treatment is available in more advanced instances (curvatures greater than 40 degrees).
Idiopathic scoliosis can only be diagnosed when all other potential causes of the deformity have been studied and none of the prospective causes provides a requirement for the creation of the deformity. Most doctors recognised the importance of the family element in the development of idiopathic scoliosis. Furthermore, when the family history of people with scoliosis is examined, it is discovered that 30% of them have mild or severe scoliosis.
Idiopathic Scoliosis Causes?
Idiopathic scoliosis is a kind of scoliosis whose cause is unknown, as the term idiopathic has already been defined. This type of scoliosis does not have any of the potential causes of scoliosis. The origins of idiopathic scoliosis are unknown, but when the family history of idiopathic scoliosis cases is reviewed, a rate of 17-42% is observed, raising the possibility that idiopathic cases can be inherited.
Idiopathic scoliosis, the most prevalent type of scoliosis, usually appears in early adolescence and childhood, but it can also be seen in adults. Scoliosis instances, which are designated according to the origin of the condition (such as idiopathic and congenital scoliosis), are also categorized according to the age of the individual in the most broad field.
Types of Idiopathic Scoliosis
For example, according to the ages at which cases of idiopathic scoliosis occur, the types of idiopathic scoliosis are as follows:
- Infantile Idiopathic Scoliosis (0-3 years old): It is a type of idiopathic scoliosis that occurs within the first three years of life and is more common in boys than in girls.
- Juvenile Idiopathic Scoliosis (4-10 years old): After the age of three, it is a type of idiopathic scoliosis that develops until the start of puberty. While the incidence is higher in boys later in life, the incidence increases in girls as puberty approaches.
- Adolescent Idiopathic Scoliosis (10-18 years): It is a spinal curvature (scoliosis) that occurs from the 1st decade until the end of puberty, when bone development stops. It is more common in girls at the beginning of puberty.
- Adult Idiopathic Scoliosis: It is a form of idiopathic scoliosis that develops late in life following bone development. Although scoliosis commonly appears in childhood, it is possible to find occurrences in maturity.
Symptoms of Idiopathic Scoliosis
Scoliosis is a type of spinal malformation that causes symptoms comparable to other abnormalities. It is typically distinguished by back and lower back curvature. However, general weariness and ache may also develop in certain patients.
In general, the symptoms of idiopathic scoliosis can be listed as follows:
- Visible curvature of the spine
- Tendency to lean to one side
- Fatigue
- Restriction of movement
- Pain
- Shortness of breath and breathing difficulties in very advanced curvatures
In addition, the increasing angle of scoliosis may worsen discomfort and cardiovascular complications. Again, some psychological issues might be detected in those with developing scoliosis angles. Low self-esteem can lead to a person seeing himself or herself as worthless.
Idiopathic Scoliosis Treatment
As with other types of scoliosis, the goal of idiopathic scoliosis treatment is to stop or decrease the advancement of spinal curvatures. Scoliosis is not defined as spinal curvatures less than 10 degrees. Observation approaches are frequently used in cases with idiopathic scoliosis (mild scoliosis) with a curvature between 10 and 20 degrees, and regular follow-ups are performed between the dates judged acceptable by the doctor to monitor the curvature. Follow-ups are typically done every 4-6 months. Corset treatment may be preferred when the curve is at danger of advancement. Adolescents with curves greater than 20 degrees are more likely to progress. Surgical procedures can be employed in patients with curves greater than 40-45 degrees and who do not respond to corset treatment.
Idiopathic Scoliosis Surgery
Although the surgical procedure is not widely used, it would be incorrect to argue that it is rarely used because scoliosis is a prevalent disorder in Turkey. The majority of patients are adolescent females, and corset treatment, remote supervision, and physiotherapy approaches are usually effective in preventing spine curvature increase. However, in severe situations (curvatures of more than 30-40 degrees), surgery will significantly enhance quality of life. In such instances, scoliosis surgery has three goals. These are:
- Stopping the progression of the curvature: It is often favoured in some exceptional circumstances if corset therapy cannot arrest the curvature. The goal is to keep the degree of curvature from rising and therefore avoiding additional potential issues.
- Reduction of deformity: Scoliosis is a condition that can cause cosmetic flaws. The curvature of the spine can have an impact on a person’s life. A surgical procedure may be considered in order to effortlessly execute social and daily life responsibilities.
- Maintaining General Body Balance: Scoliosis may cause one of the legs to seem shorter in rare circumstances. The goal of this treatment, which also covers postural abnormalities and preserving the natural curvatures of the front and back, can be a surgical option to restore the person’s quality of life.
Fusion Treatment in Scoliosis Surgery
Although surgery is not always necessary, fusion therapy is the most commonly utilized surgical procedure nowadays. Metal screws and rods are utilized to connect the vertebrae in this surgical technique, which involves fusion of the affected vertebrae. As a result, a new, movement-restricted vertebral structure is formed. This surgical technique, which is done to speed up healing and stop the curvature, also limits the mobility of the vertebrae, limiting the patient’s motions to some extent. Nonetheless, it is a recommended procedure for idiopathic scoliosis surgery since it is long-term successful.
Vertebral body tethering surgery (scoliosis surgery without fusion) is a procedure that can be utilized for idiopathic scoliosis surgery in addition to fusion surgery.
