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Medical Units - Spine Surgery

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Number of Scoliosis Surgery= 370 / year

Emsey Hospital;
Surgical Site Infection Rate:  0,07
Hospital Infection Rate: 0,70% 
Results are in referance range according to CDC criterias.

- Scoliosis is a term that defines abnormal curvature of the spine. The spine, from the rear view, is straight, but when looked up from the side has a very slight S-shape curvature. 
A person diagnosed with scoliosis may have a curve or S-shaped spine from the rear view. These curves may look like a severe S curves, called double curves, or a C-shape curve in the spine, severely throwing off upper body support and causing walking difficulty, limited range of motion, and for some individuals, breathing difficulty.
- Scoliosis may cause conditions called hypokyphosis, a condition where inadequate backward curving of the upper spine causes pain, compressed nerves and limited mobility. Another condition, called hyperlordosis, is more commonly known as sway back. A condition where the curve of the upper back is especially pronounced produces a rounded back known medically as kyphosis or hyperkyphosis.
- Treatment for scoliosis will depend on the age of the patient and the severity of the curvature.

 

The patient may also need the following tests: 

X-rays: 
Several x-ray pictures may be taken of your child's spine, including views taken from the back and sides. Your child's caregiver will carefully look at the x-rays to check the curve or shape of the spine. Other problems, such as broken, incomplete, or fused bones may also be seen. Your child's caregiver may also check if your child's bones are still growing. 

CT scan: 
This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your child's body. It may be used to look at your child's bones, muscles, brain, body organs, and blood vessels. Your child may be given dye by mouth or in an IV before the pictures are taken. The dye may help your child's caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if your child is allergic to shellfish, or has other allergies or medical conditions. 

MRI: 
This test is called magnetic resonance imaging. During the MRI, 3-D (three-dimensional) pictures are taken of your child's body. An MRI may be used to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his MRI. Never enter the MRI room with an oxygen tank, wrist watch, or any other metal objects. This can cause serious injury.

 

Curve: 
One of the most drastic benefits of scoliosis surgery is stopping the progressive curvature of the spine. Not only will this help alleviate health issues associated with scoliosis, but it will also help from a cosmetic standpoint.
Lung and Heart Health: 
Scoliosis can have a negative effect on heart and lung health. Damage to these organs occurs as the curve reaches 70 degrees. A curve of 100 degrees can cause serious damage, especially as the rib cage begins to press against the heart and lungs. By performing surgery early enough in the progression of the disease, the spinal curve can be stopped before it causes further damage.

Future Prevention:
Some advantages of scoliosis surgery are not necessarily immediate. Catching scoliosis early on and preventing it from progressing can save the patient from developing other painful related issues such as chronic back pain, arthritis of the spine etc.

 

- Scoliosis surgery focuses on fusing the vertebrae along the curve part of the spine and grafting bone chips to help encourage growth of the spine in a straighter pattern. Bone grafts are used synthetic graft.
- In addition to the bone grafting procedures, metal rods, screws, wires and hooks may be implanted until the spine fuses and grows strong enough to support itself. In most cases, such devices are left in the back without causing any health problems or issues, but will again depend on the type of surgery and the successful fusion of vertebrae. 
- Fusion procedures usually heal within 3 to 12 months, depending on severity of the curvature, surgical approach, and the overall condition of the vertebrae.

Surgical intervention should be considered:
Waist region=35-40 degrees curvature
Back region= Over 45 degrees curvature

 

Scoliosis Surgery

The scoliosis spine surgeon will choose the procedure that best treats the patient's problem. Sometimes more than one surgery produces the most favorable results. The surgeon will present the pros and cons of the different procedures so the patient and their family can make an informed decision with his guidance. 
Choices include: 
- Posterior approach (back)
- Anterior-posterior approach (front and back)
- Osteotomies (bone removal)
- Hemivertebrae excision (partial or complete removal of a vertebra)
- Kyphosis surgery
- Flatback surgery
- Vertebral column resection
- Fusion
- Correction

 

Scoliosis Surgery Recovery Timeline

- 1 day after surgery: Patient can get out of bed and walk with assistance
- 2 days after surgery: Patient can start eating more foods without feeling ill
- 2 days after surgery: Patient can take a shower (in order to keep water off the scar and prevent infection)
- 4 days after surgery: Discharge from the hospital
- 4 weeks after surgery: Patient can return to swimming
- 4 weeks after surgery: Control exam
- 8 weeks after surgery: Patient can return to work

 

- Patient can not get into trouble during x-ray / MRI with titanium platinum
- The risk of stroke is removed with neuromonitoring (nerve damage following)
- Postoperative pain control is provided with PCA (patient controlled analgesia device).
- Operation lasts 3 hours on average
- The cosmetic problem is minimized by the aesthetic suture.