Kyphosis
WHAT IS KYPHOSIS? (HUMP)
When looking at the human spine from the side, if there is a kyphosis (humpback) in your back region for balancing this situation; lordosis occurs in our waist and neck regions. Kyphosis in the chest and back region of body; varies widely among individuals. In other words, as you observe around you, some people stand more hunched while others stand more upright. In other words, the kyphosis of a person with 20 degree kyphosis and a person with 55 degree kyphosis are considered within normal limits.
WHAT IS POSTURAL (DUE TO POOR POSTURE) OR POSITIONAL HUMP?
In physiological standing; It is a positional hump that a person with 35 degree kyphosis has kyphosis due to poor posture, for example 55 degrees. This is the most common reason for the kyphosis complaint that families see in their children, and poor posture; depends on your bad sitting habit.
WHAT IS STRUCTURAL HUMP OR SCHUERMANN KYPHOSIS?
Structural hump; It is a kyphosis that cobb angle is above 55 degrees even in normal posture and often occurs due to an underlying bone or soft tissue pathology. However, the most common cause of structural hump in growing patients is Schuermann's disease and the cause of unknown;It is the kyphosis that occurs when the vertebraes lose their rectangular shape and become triangular.
HOW WE DISTINGUISH THE KYPHOSIS THAT NEEDS TO BE TREATED AND THE POSTURAL KYPHOSIS?
With a test that families can easily do, the two can be distinguished from each other. If your child can clearly correct his/her current hump when you tell him/her to stand up straight, this is most likely a postural kyphosis. The thing to note here is where the kyphosis is corrected. If the hump is corrected from its most protruding place, there is no problem. Sometimes the most protruding part of the kyphosis is not corrected at all, and there may be some improvement from the upper and lower vertebrae.
HOW CAN POSTURAL KYPHOSIS BE TREATED? WHAT CAUSES POSTURAL HUMP AND HOW TO PREVENT IT?
The most important causes of postural kyphosis are sitting in a poor position and lack of physical condition. Today, children unfortunately stay away from games or sports activities that enable them to move. And they spend most of their time at school or watching TV at home. This lifestyle causes; them to spend more time in a poor sitting position and also causes them to have a low physical condition because they cannot do sports. These are the most important causes of postural kyphosis. We would like to remind you that; heavy school bags are not blame of this situation. However, heavy school bags are generally not suitable for spinal health.
HOW IS KYPHOSIS TREATED?
In treatment; Observation, exercise and surgical treatment are among the options. Exercise therapy may be appropriate for mild to moderate Schuermann's kyphosis. The best expected success from exercise is that the kyphosis does not progress beyond the detected level.
WHEN THE SURGICAL TREATMENT NECESSARY?
In Schuermann's kyphosis; There is a general consensus that surgical treatment is required for curves above 75 degrees. In this deformity, the most preferred method today is posterior instrumentation and fusion, as in scoliosis. In very severe curvatures, corrections made by removing a piece of the spinal bone, which we define as osteotomy, can be added to this process.
HOW CAN POSTURAL KYPHOSIS BE TREATED?
In order to prevent postural kyphosis, it is necessary to eliminate its causes first. Today's children; Of course, it is not a realistic approach keeping away from the school, classroom and computer. Children's study tables and chairs; It will be a good start to ensure that it is in the appropriate position, angle, height, and adjusting. Then the monitor and keyboard heights to the appropriate positions. Another important issue is to persuade and motivate our children to spare time for sports. Sport; It will prevent postural kyphosis by increasing your child's physical condition, strength and endurance of the muscles that hold the spine upright.
IT IS MY TURN FOR THE SURGERY. WHAT SHOULD I DO NOW?
- First of all, you will be called to the hospital where you will have your surgery, some time before the surgery.
- You must be at the specified place at the specified time on an empty stomach for blood tests, new x-ray and/or MRI and anesthesia preparations.
-Your preparations for surgery; It consists of a process that changes according to your current situation. If you have a heart, kidney or other chronic disease, this preparation process can sometimes take up to 1 week.
-After all preparations are made and the anesthesiologist's consultation for surgery is given, you will be listed for surgery and your hospitalization will be made as soon as possible.
WHEN I AM GOING TO HOSPITALIZATION, WHAT SHOULD I BRING WITH ME?
You must wear sweatpants or pajamas while you are in the hospital. In the post-operative period; Since dressing is required, the clothes you bring should be easily removable (buttoned or snap fastened at the front) and comfortable. We recommend that you bring spare clothes in terms of hygiene in case of contamination from the dressing. Bring your personal care items such as toothpaste, toothbrush, shaving kit, towel for your daily personal hygiene.
HEALING PERIOD AT HOME
What to do after the operation;
• You need to have the surgical area dressed in sterile conditions (at the health center or the nearest hospital or by calling a home dresser) every two days.
• Consult your doctor as soon as possible in case of infection (inflammation) symptoms such as discharge at the wound (sutures), bad odor, severe redness that develops later, opening and temperature increase.
• Painkillers should be reduced as much as possible and they should be stopped.
• As the appetite returns to normal, healthy eating habits need to be re-acquired.
• Start taking care of yourself (such as bathing, shaving) Six weeks after surgery, many patients: - Feel well, have returned to their pre-operative energy level. - He has returned to his normal life except for activity/sport restrictions.
LIFE AFTER SURGERY
Some activity restrictions may continue between the sixth week and one year after surgery. Follow your doctor's recommendations in this regard.
• Activities to avoid unless authorized by your doctor include strenuous sports, physical training, heavy lifting, and excessive rotation or stretching of the spine.
• As time progresses, your doctor will gradually reduce restrictions.
IF WE SUMMARY WHAT YOU NEED TO DO AFTER THE SURGERY
After the surgery, your daily life activities will be studied and your exercise program will be created with a physiotherapist.
EXERCISE
• Your first day training goals:
- Sit on the side of the bed.
- If you feel well, stand up and take a few steps with your companion, within the knowledge of your doctor.
• You will be told about the blood circulation exercises that you should do through the ankle while lying down. Do it for 5-10 minutes every hour while you are awake.
FOOD
• You can drink a few sips of water at the hour the nurses say after the surgery.
• You will have an intravenous line in your arm or neck to meet your fluid needs.
• You can start consuming liquid foods (compote, soup) within the knowledge of your doctor.
REST
• It is normal to have pain after surgery. Adequate painkillers will be given by your nurse.
• Inform your nurse if you have increasing pain.
• Medications are also included in your treatment plan to relieve your nausea. If you specify, your nurse will give the medicine.
• For your comfort, you can apply ice over your incision are.
• You can put 1 pillow under your knees when lying on your back, and 1-2 pillows between your knees when lying on your side.
• You can lie on your right or left side in the bed by telling your nurse or doctor.
RESPIRATORY REHABILITATION
• Do breathing exercises with the device (triflo device) given to you every hour you are awake.
• Take deep breaths and cough often.
TOILET
• You have a urinary catheter. If you do not have a urinary catheter, get help to use a urine container or to go to the toilet.
• It is expected that you will experience constipation during this period. Your treatment plan includes anti-constipation medications.