DEFORMITY SURGERY

WHAT IS DEFORMITY SURGERY?

You may have some knowledge about deformity surgery, or this may be the first time you're hearing about it. Before defining deformity surgery, it's essential to clarify what deformity is. In healthy individuals, the spine has a normal alignment. In the anterior-posterior view, the spine appears as a straight line, while in the lateral view, it shows two gentle curves. The cervical region (neck area) is slightly lordotic, the thoracic region (back area) is kyphotic, and the lumbar region is also lordotic, each having a certain curvature. The spine constitutes the main skeleton of the body.

We can precisely answer the question of what deformity is at this point. Deformity is the disruption of the physiological alignment of the spine due to congenital structural abnormalities or later causes such as tumors, trauma, fractures, degeneration, or past surgeries. While this disruption may only cause shape abnormalities in some patients, in others, it can lead to clinical conditions related to nerve or spinal cord compression. In patients with severe scoliotic or kyphotic deformities, serious pressure on vital organs such as the heart and lungs may be observed. Deformity can restrict mobility and cause significant pain to the patient in the affected area. Therefore, early diagnosis and treatment of the disease are crucial. Deformity surgery plays a significant role in this treatment process.

HOW IS DEFORMITY DETECTED?

Spinal deformity is an abnormal alignment or curvature of the vertebral column. The most common types of deformities are scoliosis and kyphosis. Scoliosis is a three-dimensional rotational curvature of the spine. This curvature can manifest itself in an 'S' or 'C' shape and can range from mild to moderate to severe. In the presence of scoliosis, asymmetry between shoulder heights, between both hip heights, asymmetry in waist curves, and asymmetry between the right and left chest cages on the back can be observed. Symptoms may include not only shape abnormalities but also pain or stiffness radiating down from the middle of the back and numbness or weakness in the legs or feet. Not all adults with degenerative scoliosis experience pain. When pain occurs, it is often due to a pinched nerve rather than the curvature itself. Kyphosis is an abnormal forward curvature of the spine. In advanced stages, patients may even have difficulty seeing in front of them while walking.

HOW IS DEFORMITY SURGERY PERFORMED?

Corrective surgeries for spinal deformities must be meticulously planned. During the preparation phase of this operation, detailed examinations are conducted on patients to determine the most suitable surgical treatment plan. The use of the most appropriate angled implants is ensured with newly developed software. When deformity occurs in the spine, the purpose of resorting to surgical methods is to eliminate the pressure on the spinal cord caused by the deformity and to restore the spine to the most suitable physiological alignment for the patient, thereby alleviating the patient's complaints.

Implants are used during surgery to restore the spine to its appropriate physiological alignment. The implants placed in the body during the operation have no impact on the patient's daily life. With these implants, the patient can continue their daily activities. This operation significantly reduces the patient's complaints and aims to correct the deformity as much as possible.

WHAT ARE THE RISKS OF DEFORMITY SURGERY?

Like all surgeries, deformity surgeries requiring spinal stabilization also carry various risks. Among the general risks of surgery are those related to anesthesia, as well as complications such as nerve injuries, spinal cord damage, major vascular injuries, dural tears, and screw malpositioning that may occur during surgery. Similarly, after surgery, there is a possibility of various problems such as pneumonia, blood clots in the legs, lung infections, and wound infections. Performing such a large and complex operation requires a highly experienced team and various medical equipment and devices. Deformity surgeries performed in this way mostly result in success.

RECOVERY AFTER DEFORMITY SURGERY

The required recovery time after spinal deformity surgery can vary for each patient. Many patients can walk on the same day as the surgery. The length of hospitalization varies from 3 to 7 days depending on the patient. Some patients may require a physical therapy program.

WHO UNDERGOES DEFORMITY SURGERY AND HOW?

In cases of deformities that occur in the newborn period, the cause of the deformity should be identified, and treatment should be performed accordingly. Sometimes the cause may be due to fusion of spinal bones or excess bones, and sometimes it may be due to spinal cord tension. Treating the cause will often lead to the correction of the curvature over time.

Permanent fusion surgeries in childhood cases where the curvature appears during childhood should preferably be performed after the child's development is complete. Growing rod systems placed in the spine are used to allow both correction and growth in children by allowing growth. In cases of scoliosis that occur during adolescence, the choice of surgery varies according to the type of curvature, with some patients undergoing surgery allowing flexibility with the distraction method, while others undergo spinal correction with fusion surgeries. In adulthood, scoliosis or kyphosis due to various reasons should be primarily treated. Nerves under pressure should be relieved first, and then correction should be performed to achieve the most suitable alignment for the patient. The treatment for each patient is different.

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