In case I have scoliosis, how will I know?
Initially diagnosed scoliosis all have back deformity as the main symptom, especially manifested as asymmetrical posture when standing, such as unequal shoulders, one shoulder blade protruding backwards, and asymmetrical forehead and chest. There is a simple and easy way to check for scoliosis is to naturally drop your hands, bring them together, and then bend at 90 degrees. If there is scoliosis, there can be unequal height of the back or waist on both sides, commonly known as razorback deformity. Severe scoliosis can lead to thoracic rotational deformity, upper body tilt, thoracic sagging, trunk shortening and decreased activity endurance due to decreased thoracic volume, shortness of breath, palpitations, etc. A few patients may experience low back pain. In some cases, it is necessary to see a doctor for this condition.
Is scoliosis caused by drinking too little milk or eating too much unhealthy food?
The cause of scoliosis is unknown and has little to do with diet from an etiological point of view, but adolescents also need to pay attention to a balanced impact and supplementation of essential minerals and vitamins. Because some studies have shown that some patients with idiopathic scoliosis have reduced bone mass, it is especially important to pay attention to a healthy diet.
What are the dangers of scoliosis?
The first is the effect on appearance. Patients usually have unequal shoulders and a bulging back, which prevents them from integrating into normal social life and may even produce some psychological disorders.
Secondly, milder scoliosis can also cause varying degrees of thoracic deformity and reduced thoracic capacity, but generally does not affect cardiopulmonary function. Early-onset or severe scoliosis or anterior scoliosis can lead to impaired lung expansion and even localized pulmonary atelectasis on the convex side.
Since interstitial lung development is usually completed around 10 years of age, scoliosis occurring before then can lead to impaired lung development and affect cardiopulmonary function.
Severe scoliosis can compress the spinal nerves and lead to numbness, weakness, and other symptoms of paralysis in the lower extremities.
In addition, the curvature of the spine leads to bilateral muscle imbalance, and the muscles, ligaments, and soft tissues on both sides are under long-term asymmetric stress can induce muscle fatigue, low back pain, and spinal degeneration.
Why do children get scoliosis?
Scoliosis can be caused by dozens of etiologies, and about 80% of clinical cases are idiopathic scoliosis, while others are congenital, metabolic, and neuromuscular in origin (such as cerebral palsy).
Idiopathic scoliosis is a spinal deformity whose pathogenesis is unknown, and its pathogenesis is currently thought to be related to the following factors.
(i) Genetic factors: Epidemiological studies of idiopathic scoliosis have shown the influence of significant genetic factors in certain families. Although there is a lot of information on the role of genetic factors in the development of idiopathic scoliosis, the specific mode of inheritance and causative genes are not known.
( ii) Hormonal influence: The height of girls with idiopathic scoliosis is higher than that of controls of the same age, leading to the thought that growth hormone may be one of the etiologies, and it has been found that the release of growth hormone and growth-promoting factors is significantly altered in patients with idiopathic scoliosis, but it is still in the research section.
( C) Growth asymmetry factors : Possible factors are 1. asymmetric growth of the anterior and posterior columns of the spine. 2. asymmetric rib growth and asymmetric blood supply to the ribs. 3. abnormal development of the concave vertebral plates, articular processes and vertebral bodies of the main arc of scoliosis.
(iv) Abnormal connective tissue development : In patients with idiopathic scoliosis joint laxity and qualitative and quantitative abnormalities of collagen and proteoglycans in connective tissue can be found. Whether this is a primary or secondary factor in scoliosis has not yet been determined
(e) Neuro-balance system dysfunction: The function of the human balance system is to control the various forces of gravity acting on the body and to maintain balance in various states.
(f) Abnormalities of the neuroendocrine system : It has been found that pinealectomy in chickens can induce scoliosis, and this scoliosis can be prevented by melatonin. The neuroendocrine theory suggests that a decrease in serum melatonin may be an important initiating factor in the development of scoliosis and is associated with the progression of scoliosis.
(vii) Others : Some clinical observations have revealed that the mothers of the idiopathic scoliosis population are older than controls, i.e., the offspring of older mothers are prone to idiopathic scoliosis and also progress rapidly.
What are the goals of scoliosis surgery? What can we expect?
The goals of surgery for idiopathic scoliosis are: to prevent progression of the deformity; to restore the spine, trunk, and overall balance; to correct the deformity; and to prevent nerve damage.
The patient’s greatest expectation is usually an improvement in appearance, a flattening of the back, and no more bulging, which we try to achieve and most patients are discharged more satisfactorily.
At the same time, the spine surgeon will consider deeper issues such as the patient’s overall balance, pelvic level, gait regulation, prevention of nerve damage, and patient safety.
How much correction can we expect to get?
Do not expect a 100% return to normal, as the surgery also takes into account the tolerance of the patient’s spine and spinal cord, and excessive correction can lead to nerve damage or even paralysis.
The degree of correction of scoliosis varies by age and angle and etiology, usually between 60-80%.
How large will the surgical incision be? How long will the scarring period be?
The surgical incision varies depending on the choice of access and the length of the accumulated deformity.
The trend now is towards small incisions and minimally invasive surgery, and the right patient can even have orthopedic surgery done through a few small 1 cm holes, which is already known as a reality in our area.
The use of advanced intradermal suturing techniques postoperative scarring is a significant improvement over what was previously seen.
Which vertebrae are typically fused during corrective spine surgery?
Depending on the extent of the deformity accumulation, the usual principle is to fuse from the superior to the inferior end of the deformity, but for some specific types we can selectively fuse to ensure more mobile segments.
Can the implant be seen or felt through the skin?
In the case of posterior surgery, there is subcutaneous fat and muscle between the skin and the implant, which is usually not the case, although it is possible in very thin patients.
If the spine is partially fused, how tall can I expect to grow compared to if it is not fused?
In younger patients, the need to fuse the spine is sometimes forced by the condition and some height is sacrificed.
Of course, the more mature you are at the time of surgery, the less likely you are to lose this height.
What is the “crankshaft phenomenon,” and when does it occur?
Some patients who are not mature enough to undergo posterior surgery alone may experience increased deformity even if the posterior fusion is well fixed, mainly because the posterior spine growth is blocked after surgery, while the anterior spine still has great growth potential, which can lead to deformity growth as the spine grows after surgery. If this occurs it usually begins to occur 1-2 years after surgery. Of course, experienced surgeons will try to prevent this from happening.
How should I treat the pain after surgery?
There is now advanced PCA (Patient Controlled Analgesia), where the pain is self-controlled by the use of pain medication, and with this technique the patient usually returns to normal very quickly after surgery with very little pain.
How soon after surgery can I get up and walk on the floor?
Patients with common idiopathic scoliosis can get up 3-4 days after surgery and gradually walk under the direction of a nurse.
How soon after surgery can I drink and eat?
Orthopedic scoliosis surgery usually has no effect on diet. Due to the anesthetic medication, it is usually necessary to wait until 6 hours after surgery to eat.
Do I need physical therapy after surgery?
Physiotherapy after scoliosis orthopedic surgery can significantly help patients recover as soon as possible. From the first day after surgery, physiotherapy begins, instructing patients how to turn around, exercise their lower extremities, how to walk on the floor, and precautions for daily life are all part of physiotherapy.
What kinds of surgical procedures are available?
Anterior surgery, posterior surgery, and combined anterior and posterior surgery.
The choice of surgical approach is made by the spine surgeon after a series of x-rays, MRI or CT and other analysis of imaging data, careful physical examination and other ancillary examinations, based on the patient’s age, type of scoliosis, angle, and cumulative site, as well as the surgeon’s own clinical experience and skill level.
Do I need a special air mattress?
No. Patients can turn over immediately after surgery and usually do not need an air bed.
When can I bathe after surgery?
You can shower once the wound has healed, usually about 10 days after surgery.
How long after surgery can I go back to school?
You will be able to return to school 1-2 months after surgery.
Do I need to remove the staples from my body later?
The implants are used to orthose and fix the spine, but we also perform spinal fusion surgery, so the patient’s own spinal fusion is needed to maintain the final orthosis.
Can I still get pregnant if I have scoliosis surgery?
Orthopedic spine surgery does not affect the patient’s ability to become pregnant. On the contrary, some scoliosis can affect the patient’s ability to become pregnant due to the collapse of the trunk and the reduction of the pelvic abdominal volume.
Do I need any special diet and should I drink more milk to help my spine recover?
A healthy diet, without any partiality, is fine.
Is there any restriction of movement after scoliosis surgery?
No. Spinal fusion surgery can sacrifice some of the movement of the spine, but the curvature of the spine is concentrated in the lumbar segment, especially the lower lumbar segment, and spine surgeons take this into account when planning the surgery.
Most patients will have at least 1-2 segments preserved.
What is the difference between open surgery and endoscopic surgery?
The main difference is a smaller surgical incision, avoiding longer scars that affect the appearance after surgery, less damage to the muscles and soft tissues during open surgical exposure, less postoperative pain, faster postoperative recovery, and shorter hospital stays.
How do you think about post-surgical complications?
It is a fact that surgical complications are unavoidable, that is medicine, but such complications can be minimized by excellent technique, profound expertise, high responsibility and advanced medical aids.
Many times you cannot choke on it. The car is good, there are car accidents every day, but modern society cannot deny its existence.
Surgery can certainly be traumatic, but it is necessary when the benefits to the patient far outweigh the potential damage.
Orthopedic spine surgery is not just a matter for the surgeon, but requires the cooperation of the patient and parents before and after surgery.
Is there any chance that the foreign bone implanted during scoliosis surgery will be absorbed by the body later? How long will the external brace be worn after surgery? Is there a possibility of re-bending?
The patient’s own bone is used as much as possible during surgery, and only if there is not enough bone or bone graft substitutes are used.
Rest assured that the implants that enter the body have undergone many years of laboratory research, animal testing, and inspection by the national authorities. These bones will gradually be replaced by the own bone and fusion will be achieved.
The vast majority of patients do not require a brace after surgery.
The possibility of deformity progression in the fixed area after internal fixation is minimal.
What is the actual size of the incision for the endoscopic procedure?
Usually 4 incisions of 1-2 cm each.
How long will I have to stay in the hospital after the endoscopic surgery?
You can be discharged from the hospital in 7-10 days. If you have good home care, you can remove the stitches by yourself and you can be discharged from the hospital in 2-3 days after the surgery.
What are the results of endoscopic surgery with the CDHORIZON ECLIPSE Spine System?
Small incisions are made to perform orthopedic spine surgery that can only be done with traditional long incisions.
How will I know if endoscopic surgery is right for me?
It is usually appropriate for adolescents with idiopathic scoliosis, thoracic curvature, angles of 40-70 degrees, good flexibility, good pulmonary function and some financial ability.
Will it be painful after the endoscopic surgery?
There will be some pain, but it is much less than traditional open surgery.
Can I take a shower after endoscopic surgery?
You can take a shower 1 week after the surgery.
What are the restrictions after endoscopic surgery?
Avoid vigorous impulsive activities for 3-6 months in the early postoperative period, but daily school life is not affected.
How long does it take before I can exercise again after endoscopic examination of the hand?
Gradually start adaptive exercise 3 months after surgery and gradually increase the intensity of exercise.
Do I need to take any medication if endoscopic surgery is performed?
No special medication is required.
Is there any restriction or impact on my future activities as a result of the endoscopic surgery?
Minimally invasive surgery is less invasive than traditional surgery, has a shorter recovery time, and has a relatively shorter fixed segment, thus having less impact on future activities.