Myths About Scoliosis

Early diagnosis of scoliosis, which is defined as the rotation of the spine on its own axis and curvature to the side, and which is encountered by 100 out of every 3 adolescent girls today, may be impossible during the pandemic process.

Acıbadem Maslak Hospital Spine Health, Orthopedics and Traumatology Specialist Prof. Dr. Ahmet Alanay “Spine curvature occurs most frequently in adolescence. As the growth continues, the curvatures continue to progress. Especially during adolescence growth spurt, when mild and moderate curvatures reach moderate and advanced levels within 2-3 months, treatment can become difficult and fusion surgery is the only solution. Families who hesitate to go to the hospital due to pandemic conditions may prefer to wait, since scoliosis usually does not cause pain. However, the elapsed time may cause the spinal curvatures to progress and the golden window to close for non-surgical or surgical treatments that preserve movement. For this reason, it is important to get expert opinion as soon as scoliosis is suspected, and to diagnose and treat progressive scoliosis early. Early diagnosis is important because small and moderate scoliosis can be stopped with bracing, exercise and surgical treatments that preserve motion without fusion. Prof. Dr. Ahmet Alanay, in his statement within the scope of Scoliosis Awareness Month in June, talked about the well-known misconceptions about scoliosis in our society, and made important warnings and suggestions to parents.

Early diagnosis does not help in scoliosis

This idea developed due to the belief that the brace failed, which is no longer valid, and that the only treatment is fusion surgery (fixing the vertebrae with screws and rods and eliminating the movement and growth in this region), but the data in recent years have shown that with early non-operative treatments ( corset and scoliosis-specific physical therapy exercises) have shown that curvatures can be controlled, and non-fusion spine surgery (tape stretching; vertebral body tethering, VBT) is becoming increasingly common. The success of the band stretching technique depends on the appropriate patient selection and application at the ideal time. For all these reasons, the importance of early diagnosis is increasing day by day. Early diagnosis allows for more physiological treatment methods.

Some sports cause scoliosis, some prevent scoliosis

There is no data showing that engaging in any sport at the hobby level or professionally increases the frequency of scoliosis. Similarly, there is not enough evidence that increasing muscle strength by engaging in sports activities prevents the formation or progression of scoliosis or improves scoliosis, but strengthening the posture muscles is generally good for spinal health. In addition, there are scientific data showing that physical therapy exercises specific to scoliosis, especially the application with a corset, can be effective.

Scoliosis is a painful disease

Mild and moderate scoliosis curvatures do not cause pain. The most common cause of spinal pain in individuals with straight or curved spine is muscle fatigue pain, which is expressed as mechanical pain and occurs due to muscle strength weakness. If the degree of scoliosis progresses significantly, it may cause pain, but not every back pain does not mean that the scoliosis has progressed. Similarly, pain may occur when individuals with scoliosis reach adulthood and when signs of curvature and age-related calcification appear.

Corset treatment does not work in scoliosis

The corset is still a product made by hand and mastery today. Today, there are many corset designs with different mechanisms of action. For this reason, there have been articles that published conflicting results about the success of the brace in the past years, but more recently, the effectiveness of brace treatment has been definitively shown in a study supported by the American and Canadian Ministries of Health. The most successful range of corset treatment is curvatures between 20 and 45 degrees. The most important effect of the corset is that it significantly reduces the rate of going to surgery. Apart from this, the most basic benefit expected from the corset is the prevention of the progression of the curvature. Less frequently, a decrease in the direction of improvement in curvatures can be observed.

Individuals who have had scoliosis surgery cannot do sports.

Fusion is provided in the surgical site with modern instrumentation techniques and implants. For this reason, individuals who have undergone fusion surgery can do sports after the union of the bones and screws is completed. Although all kinds of sports can be performed, including extreme sports, the appropriate sports to be performed after fusion surgery may vary according to the level of the surgery. The method of stretching with tape is a fusion-free procedure, and since bone healing is not expected, all kinds of sports activities can be performed from the early period after the surgery.

Poor posture causes scoliosis

There is not enough scientific evidence that poor posture, sitting in inappropriate positions and carrying a heavy school bag have an initiating effect on scoliosis, but conditions that cause unsymmetrical load distribution on the spine may predispose to the progression of scoliosis that has once appeared and started. Regardless of the existence, formation and progression of scoliosis, staying in bad posture for a long time, sitting incorrectly and carrying heavy loads asymmetrically are also harmful for spinal health in general.

The incidence of scoliosis has been increasing in recent years.

Over the years, especially thanks to social media, awareness of scoliosis has increased and this has created a perception as if the frequency of scoliosis has increased, whereas the incidence of scoliosis is similar in different parts of the world and has not changed in recent years. It occurs in about 3 percent of the world. Current studies conducted in our country and abroad also point to similar rates. The increase in social awareness about scoliosis has increased the early diagnosis and thus the success in treatment.

Scoliosis is a genetic condition passed from parent to child.

Genetic or hereditary diseases are passed from parents to the next generation via chromosomes and DNA. This term for scoliosis is not entirely correct. Studies conducted on identical twins with exactly the same genetic makeup have shown that if one twin has scoliosis, the probability of having scoliosis in the other twin is around 70 percent. This situation reveals the importance of environmental factors as well as genetic factors in the development of scoliosis. When all the data are evaluated together, it is seen that most of the scoliosis of unknown cause occurs coincidentally rather than being hereditary.

Surgical treatment in scoliosis cannot be performed until the age of 18-20.

There is a surgical treatment for scoliosis suitable for all ages. In growing children, non-surgical ones are chosen primarily, but success is not always achieved with these methods. In such cases, if the growth is expected to end, the curvatures may worsen to very advanced degrees and the surgeries may become more difficult and risky. Therefore, in cases where there is no response to non-surgical treatment, curvatures are controlled by the application of surgical treatments that do not stop growth, support (growing rods) or direct growth (tape stretching; vertebral body tethering, VBT).

Individuals with scoliosis cannot become pregnant or give birth

Individuals with scoliosis can have as many pregnancies as they want, regardless of the type of treatment (surgical or non-surgical), and they can have children by both normal birth and cesarean section. Individuals with scoliosis should consult their doctor before becoming pregnant if lung and heart problems have started in untreated or late treated very advanced curves.

Check your child from time to time!

Prof. Dr. Ahmet Alanay stated that parents should check their children in the rapid growth period frequently and said, “There are clinical findings such as shoulder and waist asymmetry in scoliosis, swelling on the back or one side of the waist when leaning forward. Although the cause of scoliosis is unknown, the biomechanical basis of how scoliosis progresses has been clarified. For this reason, it is useful to check the children from time to time. If there is a suspicious situation, it is absolutely necessary to consult the doctor without wasting time,” he says.