SCOLIOSIS and 3 DIMENSIONAL SCHROTH THERAPY

Scoliosis is a sideways curvature of the spine accompanied by vertebral rotation. Its prevalence is between 0.2% and 6%. Although it may be caused by trauma, birth-related developmental disorders and muscular diseases, cause is unknown for 80% of scoliosis.

It is usually noticed by the mother and father with the symptoms such as shoulder asymmetry in the child, swelling on one part of the back, and not keeping the hips at the same level. Depending on the scoliosis, deformities occur on the hips, rib cage and shoulder bones. Posture and image distortion occur. This leads to abnormal burden in the developing and growing spine and consequently deformities in the vertebrae.

Scoliosis is an important public health problem in terms of health, cosmetic, social and psychological problems due to deformity, when the young age group it affects is generally considered. Early diagnosis of scoliosis is important in controlling the progression of curvature, increasing the success of conservative treatment and decreasing surgery.

The course of scoliosis is not always same. Curvature of the spine may worsen, stay same or improve seldomly. The progress is available when there is 10° increase observed in two or more examinations in the spine having a curve of less than 20°, or when there is a 5° or more increase observed in the spine having a curve of more than 20°.

If the curvature starts before the age of 10, the gender is female, there are two curves, curvature is on the upper back, and the degree of the curve is high at the time of diagnosis, it implies that progress probability may be higher. The curves with less than 30° has lower probability of progress.

The diagnosis of scoliosis is made based on the physical examination and spinal X-ray that is taken when the patient is standing up. The appearance of an individual with scoliosis is characterized with a curvature of spine toward one side, one-sided hip asymmetry and unlevel shoulders.

TREATMENT

Scoliosis treatment is considered in four groups; observation, corset, physical medicine and rehabilitation, and surgery.

There are many physiotherapy approaches in the treatment of scoliosis. Such as Vojta therapy, acupuncture and Schroth therapy.

Scoliosis treatment can be planned in accordance with the spinal curvature degree:

• If scoliosis (Cobb) angle is less than 15°, follow-ups should be every 6 or 12 months.
• If Cobbs angle is between 15° and 25°, daily physiotherapy and additional home exercises are made under the guidance of a physiotherapist. Physiotherapy should continue for three months. After this, the exercises should be continued with the physiotherapist every two weeks.
• If the Cobb angle is between 20° and 25°, daily physiotherapy and, if possible, intensive scoliosis rehabilitation programs are recommended. These programs are commonly used in Germany and Spain and are usually 3-5 weeks, with 4-6 hours of work done each day.
• In children with cobb angle is more than 25°, daily physiotherapy programs, intensive scoliosis rehabilitation program, and 12-16 hours of corset use per day are recommended.
• Children of developmental age with a Cobb angle of 20° and 30° undergo a scoliosis rehabilitation program with or without corsets. Adults with a Cobb angle of 30° and 40° and suffering from pain also benefit from these programs.
• Surgery for children with adolescent idiopathic scoliosis is recommended for curves greater than 45° and for adults after 50°. The aim of surgical treatment is to prevent and correct the progression of curvature. Adults with uncontrolled pain need surgery.