Spinal deformity is the result of the spine not being aligned as it should be. In general, they are structural disorders of the spine. These disorders may occur for several reasons. Although it does not cause problems in most cases, it can negatively affect the life of the person if the deformity progresses. Early diagnosis and treatment is very important in spinal deformity. At this stage, the progression of curvatures or other disorders can be stopped and treated.
Spinal Deformity
What is Spinal Deformity
From the back, the spine is almost completely linear, while from the side it resembles a slight s-shape. When viewed from the side, some curvature of the spine is natural. These curvatures are physiological curvatures. There are 3 physiological curvatures: one in the neck, one in the back and one in the waist.
As a result of some conditions, disruptions and defects in the structural functions and cosmetics of the spine may occur. For example, the kyphosis in the back should be between 20 and 50 degrees. In cases where the angle greater or smaller, it is called kyphosis, which a kind of spinal curvature after being diagnosed by doctors.
The deformity may be due to the spine itself, but it is mostly in the form of spinal curvature. For example, in cases of scoliosis, the spine is displaced in the horizontal plane. The spine, which should look like a straight line when viewed from the back or front, has now shifted to the right or left in some areas.
Types of spinal deformity
Scoliosis
Contrary to what many people think, scoliosis is not the only spinal deformity. It can also occur in other conditions. Scoliosis spinal deformity is the most well-known of these. It can be defined as curvatures of more than 10 degrees in the horizontal plane of the spine. In the treatment phase, a scoliosis corset and some exercises are generally recommended to stabilise the curvature and stop its progression. In severe curvatures (curvatures of more than 40 degrees), surgical intervention may be required.
Kyphosis
Kyphosis is a type of spinal deformity that is not well known. Although it is not known, it is more dangerous than scoliosis. It can be defined as the forward curvature of the spine. Physiological (completely natural) curvatures in the spine may increase due to some reasons. In cases of kyphosis, these physiological curvatures are not within the standard values. The curvature, which should be between 20 and 50 degrees, has increased, and a hump has formed.
Lordosis
Lordosis is a condition of increased natural curvature in the lumbar region. Body weight pressing on the spine often causes pain. In these cases, patients have a visible curve in the lower back. The waist appears C-shaped.
Vertebral Slippage
Spondylolisthesis is the slipping forward of one of the vertebrae that form the spine by joining together, also known as vertebral slippage. This condition can have serious consequences. The slippage can compress the spinal cord or, in other cases, cause kyphosis. It is usually characterised by back and leg pain, muscle weakness and some movement limitations. The main types of spondylolisthesis are:
- Isthmic: develops due to bone rupture, a fracture of the vertebrae.
- Dysplastic: occurs as a result of a congenital deformity in the facet joint.
- Degenerative: is seen as a product of natural deformity that occurs with age.
- Traumatic: occurs after injuries.
Causes of Spinal Deformity
Spinal deformities can arise from several different causes. Although cases are usually idiopathic (of unknown origin), it is possible that there are different causes for different deformities. The causes of spinal deformities can be listed as follows:
- Idiopathic scoliosis, as is often the case with idiopathic scoliosis, has no specific cause. The origin of spinal curvatures is unknown.
- Degenerative is related to the wear and tear of the spine over time. In ageing people, the vertebrae do not retain their former strength and may become deformed for some reason. This can manifest itself in the form of other spinal problems.
- Congenital is related to the prenatal period. A problem that develops during this period can cause spinal deformity.
- In paediatric children during the period of rapid growth, such spinal deformities can be detected more often. Spinal deformity is included in this group if it developed in childhood. In cases of scoliosis, early treatment is very important for children in the rapid growth period in order to prevent progression of the curvature.
- Some problems affecting neuromuscular and muscle activity can change the stiffness of the muscles. This may cause spinal deformity.
- Postural is related to physical errors in the growth process of the spine. Wrong sitting styles and general posture disorders in the developmental age can cause this.
- Traumatic, a heavy blow to the spine can change its angle. It can develop after cases such as accidents and injuries.
In some cases, other spinal deformities may be the cause of another deformity. For example, spondylolisthesis can sometimes cause kyphosis.
Symptoms of spinal deformity
Spinal deformities are generally characterised by pain. These deformities should be taken seriously. They can affect people’s lives from beginning to end and have negative consequences for daily life and psychological well-being.
Symptoms of spinal deformities can be visible inward shifts in the lumbar region, neck and back pain, hunchback in the upper back, heart and lung problems in some cases, some visible cosmetic defects, unequal leg lengths, unequal shoulder heights.
Back and shoulder pain, excessive fatigue, breathing problems and pain are symptoms of kyphosis, while the lumbar indentation (c-shaped) that retains its shape after lying on a hard surface, back pain, reduced ability for certain movements are among the symptoms of lordosis.
Shortness of breath and, in particular, one side of the lower back being lower or higher than the other can be a sign of scoliosis. In such a case, the hands are joined in front and the two palms are brought together. It is directed between the adjacent legs and can be checked by bending down with the arms parallel to the legs. In this case, if one side of the waist is lower or higher than the other, it is necessary to consult an orthopaedist.
Spinal Deformity in Children
The most common types of spinal deformity among children are scoliosis, kyphosis and lordosis. Especially when scoliosis is diagnosed in children in the age of rapid growth, the treatment changes significantly in a positive direction. It usually presents with symptoms such as lower back and back pain, cosmetic defects and breathing problems.
The diagnosis of spinal deformity in children is made with methods such as MRI, computed tomography (CT) as well as family, patient history and physical examination. If left untreated or if the growth of the curvature angles is not stopped, these deformities may affect daily life and cosmetic problems may affect the psychology of the patients. Since the spine maintains its flexibility and bone development is not complete, serial casting, corsets or exercises may be recommended. However, depending on the severity of the case, surgical method may also be preferred.
Vertebral body tethering scoliosis surgery, which can be applied for children who continue to grow, is also a method used for the treatment of scoliosis in children.
Treatment of Spinal Deformity
There are two main methods for the treatment of spinal deformity. These are non-surgical methods and surgical interventions. These treatments, which can be done to stop the progression of curvatures and reduce pain, will vary according to the severity of the case.
Lordosis Treatment
When it comes to the treatment of lordosis, it may vary according to the severity of the curvature, pain and swelling. In cases where the curvature is flexible, treatment may not be required, while in cases where it is not flexible, physiotherapy or surgery may be used. In such a case, the progression of the disease may lead to problems such as obesity, shortness of breath, etc. Cosmetic problems are also a problem on its own.
Kyphosis Treatment
If the forward curvature of the spine exceeds 55 degrees, physical therapy and some exercises are used to stop the progression of the case. In cases where these are insufficient, kyphosis surgery can be performed. In addition, prescription or non-prescription painkillers may be recommended for pain.
Scoliosis Treatment
Scoliosis often occurs in children and adolescents. For growing children, the use of a scoliosis brace may be recommended. Although this prevents the movements of the spine to some extent, it stops the progression of the curvature to a great extent. However, corsets are not recommended for adults. In general, scoliosis physiotherapy or surgery may be preferred depending on the severity of the curvature. Generally, scoliosis surgery is preferred for curvatures over 40 degrees (severe scoliosis).
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