MEHMET FATİH KORKMAZ, REŞİT SEVİMLİ, ENGİN BURAK SELÇUK, YILMAZ ÇİĞREMİŞ

Üç Boyutlu Omurga Deformitesi: Skolyoz

Spinal kolon ortalama 33 ayrı vertebranın üstüste sıralanıp birbirlerine bağlanması ile meydana gelen bir sütundur. Bu sütunun primer görevi, baş, göğüs ve karın içi organları taşımak ve bunlara bir destek olmanın yanında spinal kanalı oluşturup, içinden geçen medulla spinalise sağlam ve emniyetli bir kılıf oluşturmaktır. Yeni doğanda spinal kolon düz bir sütun halinde olup bebek başını tutmaya başlayınca servikal lordoz oluşmaya başlar. Oturmaya ve ayağa kalkmaya başlayınca torakal kifoz, lomber lordoz ve sakral kifoz gelişir. Normal bir omurganın yandan bakıldığında fizyolojik eğrilikleri olmasına karşın, ön-arka planda olan her eğrilik patolojiktir. Skolyoz,omurganın lateral deviasyonu, sagittal eğiminde azalma ve aksiyel rotasyonu ile karakterizedir. Diğer bir tanımla, X-ray ile değerlendirildiğinde, omurganın normal vertikal hattının 10 dereceden daha fazla deviasyonudur. Skolyozun tedavisinde kullanılan tüm tedavi yöntemlerinin amacı, kozmetik açıdan düzgün, dengeli, ağrısız ve stabil bir omurga sağlamaktır. Skolyozun tedavisinde farklı yöntemler kullanılmasına karşın ileri tedavi arayışları devam etmektedir.

Three-dimensional Spinal Deformity: Scoliosis

In human body, average of 33 separate vertebrae of the spinal column is sorted and connected to each other in a row. The primary task of this column is to support the head, chest and abdominal organs and form a stable and strong sheath to the spinal canal where the medulla spinal passes through. Spinal column of a new born baby is straight, but after the baby starts to hold his head, cervical lordosis is formed. After the baby starts to sit and stands up, thoracic kyphosis, lumbar lordosis and sacral kyphosis develops. Although, normal physiological curves of spine is normal, deviations from the front or rear view is considered pathological. Scoliosis is characterized as lateral deviation, the reduction in sagittal slope and axial rotation. Scoliosis can also be defined as the deviation of the normal vertical line, deviating more than 10 degrees, as seen in X-ray. All treatment methods used in the treatment of scoliosis aims to perform physically normal, balanced, painless and a stable backbone. Although, the treatment of Scolyosis is performed in several different ways, further studies are still being conducted.

PDF

___

1. Weinstein SL, Buckwalter JA, eds, Turek's Orthopaedics Principles and Their Application. 6th edition. Philadelphia: Lippincott Williams & Wilkins, 2005;482- 92.
2. Kotwicki T. Evaluation of scoliosis today: examination, X-rays and beyond. Disabil Rehabil. 2008;30(10):742-51.
3. Perez KA, Dormans JP. Spinal disorders. In: Dormans JP, ed, Pediatric Orthopaedics: Core Knowledge in Orthopaedics. Chapter 11. 1st edition. Philadelphia: Elsevier Mosby, 2005;265-78.
4. Bunnell WP. The natural history of idiopathic scoliosis. Clin Orthop Relat Res. 1988;229:20-5.
5. Weinstein SL. Natural history. Spine (Phila Pa 1976). 1999;24(24):2592-600.
6. Basu PS, Elsebaie H, Noordeen MH. Congenital spinal deformity: A comprehensive assessment at presentation. Spine (Phila Pa 1976). 2002;27(20):2255-9.
7. Nachemson AL, Peterson LE. Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. J Bone Joint Surg Am. 1995;77(6):815-22.
8. Yawn BP, Yawn RA, Hodge D, Kurland M, Shaughnessy WJ, Ilstrup D, Jacobsen SJ. A population based study of school scoliosis screening. JAMA. 1999;282(15):1427-32.
9. Dickson RA. Spinal deformity-Adolescent Idio-pathic Scoliosis. Spine (Phila Pa 1976). 1999;24(24):2601-6.
10.Lonstein JE, Carlson JM. The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am. 1984;66(7):1061-71.
11. Graham JJ. Medical management of scoliosis. In: Goodgold J, ed, Rehabilitation Medicine. Missouri: Mosby Company, 1988:476-94.
12. King HA. Orthotic management of idiopathic scoliosis. In: Kraft GH, Lehmann JF, eds, Physical Medicine and Rehabilitation Clinics of North America. Philadelphia: W.B. Saunders Company, 1992:45-57.
13. Freidel K, Petermann F, Reichel D, Steiner A, Warschburger P, Weiss HR. Quality of life in women with idiopathic scoliosis. Spine (Phila Pa 1976). 2002;27(4):E87-91.
14.Lonstein JE. Orthotic treatment of spinal deformities: scoliosis and kyphosis. In: Bunch WH, Keagy R, eds, Atlas of Orthotics. St. Louis: Mosby Company, 1985:371-86.
15.Lowe T, Berven SH, Schwab FJ, Bridwell KH. The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems. Spine (Phila Pa 1976). 2006;31(19 Suppl):S119-25.
16. Goldberg CJ, Dowling FE, Hall JE, Emans JB. A statistical comparison between natural history of idiopathic scoliosis and brace treatment in skeletally immature adolescent girls. Spine (Phila Pa 1976). 1993;18(7):902-8.
17. Aebi M. The adult scoliosis. Eur Spine J. 2005;14(10):925-48.
18.Rowe ED, Bernstein SM, Riddick MF, Adler F, Emans JB, Bonneau-Gardner D. A meta-analysis of the efficiacy of non-operative treatments for idiopathic scoliosis. J Bone Joint Surg. 1997;79(5):664-74.
19. Yamada K, Yamamoto H, Nakagawa Y, Tezuka A, Tamura T, Kawata S. Etiology of idiopathic scoliosis. Clin Orthop Relat Res. 1984;184:50-7.
20. Samuelsson L, Undeli O, Kogler H. Spinal cord and brain stern anomalies in scoliosis. MR screening of 26 cases. Acta Orthop Scand. 1991;62(5):403-6.
21.Tachdjian MO, Matson DD. Orthopaedic aspects of intraspinal tumors in infants and children. J Bone Joint Surg Am. 1965;47:223-48.
22.Isu T, Chono V, Iwasaki V, Koyanagi i, Akino M, Abe H, Abumi, Kaneda K. Scoliosis assoeiated with syringomyelia presenting in children. Childs Nerv Syst. 1992;8(2):97-100.
23. Machida M. Cause of İdiopathic scoliosis. Spine (Phila Pa 1976). 1999;24(24):2576-83.
24. den Boer WA, Anderson PG, v Limbeek J, Kooijman MA. Treatment of idiopathic scoliosis with side-shift therapy: an initial comparison with a brace treatment historical cohort. Eur Spine J. 1999;8(5):406-10.
25. Qiu G, Zhang J, Wang Y, Xu H, Zhang J, Weng X, Lin J, Zhao Y, Shen J, Yang X, Luk KD, Lu D, Lu WW. A new operative classification of idiopathic scoliosis: a peking union medical college method. Spine (Phila Pa 1976). 2005;30(12):1419-26.
26.Lewonowski K, King JO, Nelson MD. Routine use of magnetic resonance imaging in idiopathic scoliosis patients less than eleven years of age. Spine (Phila Pa 1976). 1992;17(6 Suppl):S109-16.
27.Ecker ML, Betz RR, Trent PS, Mahboubi S, Mesgarzadeh M, Bonakdapour A, Drummond DS, Clancy M. Computer tomography evaluation of CotrelDubousset instrumentation in idiopathic scoliosis. Spine (Phila Pa 1976). 1988;13(10):1141-4.
28. Sar C, Hamzaoglu A, Domanic U, Goksan B. Idiopatik skolyozda manyetik rezonans goruntulemenin yeri. Acta Orthop Traumatol Turc. 1994;28:203-6. 29. Shirado O, Toshikazu I, Kaneda K, Strax TE. Kinesiologic analysis of dynamic side-shift in patients with idiopathic scoliosis. Arch Phys Med Rehabil. 1995;76(7):621-6.
30. Dickson RA. Spinal deformity-Adolescent Idio-pathic Scoliosis. Spine. 1999;24(24):2601-6.
31.Terek R, Wehner J, Lubicky JP. The crankshaft fenomenon in congenital scoliosis. J Pediatr Orthop. 1991;11(4):527-32.
32. Dimeglio A, Canavese F, Charles P. Growth and adolescent idiopathic scoliosis: when and how much? J Pediatr Orthop. 2011;31(1 Suppl):S28-36.
33. Kuhns JE, Hormell RS. Management of congenital scoliosis. AMA Arch Surg. 1952;65(2):250-63.
34.Lee CF, Fong DY, Cheung KM, Cheng JC, Ng BK, Lam TP, Mak KH, Yip PS, Luk KD. Referral criteria for school scoliosis screening. Assessment and recommendations based on a large longitudinally followed cohort. Spine (Phila Pa 1976). 2010;35(25):E1492-8.
35. Sponseller PD. Syringomyelia and Chiari I malformation presenting with juvenile scoliosis as sole manifestation. J Spinal Disord. 1992;5(2):237-9; discussion 239- 44.
36. Parent S, Newton PO, Wenger DR. Adolescent idiopathic scoliosis: etiology, anatomy, natural history, and bracing. Instr Course Lect. 2005;54:529-36.
37.Winter RB, Moe JH, Lonstein JE Posterior spinal arthrodesis for congenital scoliosis. An analysis of the cases of two hundred and ninety patients, five to nineteen years old. J Bone Joint Surg Am. 1984;66(8):1188-97.
38. McMaster MJ. Congenital scoliosis caused by a unilateral failure of vertebral segmentation with contralateral hemivertebrae. Spine (Phila Pa 1976). 1998;23(9):998-1005.
39.Reckles LN, Peterson HA, Weidman WH, Bianco AJ Jr. The association of scoliosis and congenital heart defects. J Bone Joint Surg Am. 1975;57(4):449-55
40. Shah Cheraghi GH. Patterns and progression in congenital scoliosis. JPO. 1999;19(6):766-71.
41.Winter RB, Moe JH, Eilers VE: Congenital scoliosis. A study of 234 patients treated and untreated. 1. Natural History. J Bone Joint Surg Am 1968;50:1-15.