Answers to Frequently Asked Questions

  • Does carrying heavy school bags or carrying the bag always on the same shoulder cause scoliosis?

    Carrying heavy school bags or carrying the bag always on the same shoulder does not cause scoliosis. However, children are generally recommended not to carry loads exceeding 5% of their body weight in order to avoid lumbar degeneration and pain.

  • Is hard mattress beds good for spinal health?

    Hard mattresses do not decrease, and may potentially increase lower back pain. A person sleeping on a hard matress will sustain greater pressures on protuberant areas of the body in contact with the bed (hip, shoulder, etc.), and as a result, will turn often. These turning movements will increase lower back pain.

    On the other hand, beds that are too soft will cause the body to bend excessively, eventually increasing the pressure due to abnormal forcing, and result in increased pain.

    Yet, there is no consensus on the best mattress for the spine. Several studies that compared different mattresses concluded that there were no differences between the water beds, semi-firm mattresses and visco-elastic bed.­

  • Why are the spinal curve magnitude and scoliometer magnitude are different values?

    These two methods quantify different aspects of scoliosis. Sideway bending magnitude is measured on radiographs, while scoliometer quantifies the rotation.


  • Why does Scoliosis Cobb angle magnitudes differ in different measurements?

    Manual and computerized measurements have 5 and 3 degrees of acceptable measurement error, respectively.

  • Does calcium deficiency cause scoliosis?

    Lack of calcium does not cause scoliosis.

  • Does poor posture cause scoliosis?

    Poor posture does not cause scoliosis.

  • Does adolescent idiopathic scoliosis cause back and/or lumbar pain?

    Scoliosis is often not a source of pain in adolescents, yet lower back pain may be observed in severe scoliosis located in the lumbar area (lowerback). Back and lower back pain may be observed in adult scoliosis.

  • Can braces (corsets) completely correct scoliosis and achieve a completely straight vertebral column?

    Braces (corsets) do not make the vertebral column completely straight.

  • Is the brace named "Spinecore" more effective than other braces? Is it the definitive cure of scoliosis?

    Experience with Spinecore brace is not as extensive as that with other braces (Milwakuee, Boston). Easier use of the spinecore brace compared to other braces may be an advantage. Nevertheless, there are no first level of evidence based data or studies which show that it is the definitive cure for scoliosis, or which demonstrate that it corrects scoliosis more successfully than other braces.

  • I will undergo a scoliosis operation, and I am a smoker. Does smoking pose a risk for spinal surgery?

    The final result of a scoliosis operation or any other vertebral operation requiring fusion is bone healing. Smoking negatively affects bone healing. Therefore, patients who will undergo an operation that requires fusion (bone healing) are definitely recommended to quit smoking.

  • I have titanium screws and rods on my back. Do they rust? Will they be rejected by my body?

    Titanium implants (instrumentation) that are used in spine surgery are generally composed of titanium alloys and cobalt-chromium. They do not rust and are not rejected by the body.

  • I have titanium screws and rods on my back. Will they activate metal detectors in airport security gates?

    Titanium implants (instrumentation) that are used in spine surgery do not activate metal detectors in the airports. Yet in very long fusions with high implant density, signalling can occur if  the detectors are very sensitive. Please obtain a report explaining your surgery and implants.

  • Does pregnancy increase the severity of scoliosis?

    Pregnancy does not cause an increase in the severity of scoliosis.

  • If I undergo surgery for scoliosis, will it affect my ability to give birth?

    Surgery does not affect your ability to give birth.

  • Are spinal deformities (scoliosis-kyphosis) inherited? Can it occur in my children, grandchildren, brothers or sisters?

    Deformities of the spine may be inherited, however there is no definite data on this. Research so far indicates that these diseases cannot be explained with inheritance only. That said, if there is a history of scoliosis in your family, you should closely observe your childs back during rapid growth periods.

  • I fear whether my child will develop scoliosis. How can I prevent the development of scoliosis in my children?

    Currently there are no methods which can prevent the formation of spinal deformities.

  • Which gender and age groups are most commonly affected by scoliosis?

    Scoliosis is most commonly seen between ages 10 and 16. Girls are affected 8-10 times more commonly than boys.­

  • Is it true that the rate of scoliosis is increasing recently? And why?

    The rate of scoliosis is between 1-3%. This rate is similar among various countries or races. The rate of scoliosis has not shown an increase in recent years. However, scoliosis awareness has increased and the public has become more conscious about the disorder. As a result, small-degree scoliosis that went unnoticed in the past are noticed more often today with close family observation. This creates an impression that there is a relative increase in the number of scoliosis patients.­

  • Which scoliosis is easier to treat, that of children versus adolescents?

    Although both has unique challanges, the most difficult is the treatment of scoliosis in young children. Especially in children between ages 3 and 10, scoliosis almost always progresses, and often requires surgical treatment.­

  • Can someone who does not have scoliosis during childhood have scoliosis in the future?

    Scoliosis observed at advanced age, and not previously present in childhood or puberty, may occur for two reasons. The first is that scoliosis was not noticed during puberty yet became noticeable due to an increase in adulthood. This scoliosis type is named adult idiopathic scoliosis. The second is scoliosis that occurs after age 50 and due to aging of the spine and degeneration of the tissues that provide integrity to the spine. This latter type is called “de novo” or “degenerative” scoliosis. Degenerative scoliosis is most commonly seen in the lower back area, and often associated with compression of the spinal cord or nerves.­

  • What are the recommendations that will stop either the development or the rapid progression of scoliosis?

    In a patient with scoliosis, unfortunately there is no efficiency proven method that will stop the development or rapid progression of the curve. Early diagnosis is the best way to be able to stop progression. 

    In particular, the opinions that exercise and sports (swimming, etc.) may stop progression of the curve do not rely on adequate scientific proof. However, exercise and sports provide numerous benefits for patients with scoliosis. These benefits include:

    • Increased physical conditioning and muscle power decreases the postural disorder seen with scoliosis, and may decrease cosmetic complaints due to scoliosis.
    • It is believed that patients with scoliosis have more back and lower back pain compared to the normal population. Children who have developed sports and exercise discipline may experience less back and lower back pain in the future.
    • They may facilitate postoperative recovery in children who need surgery.­­
  • What is the most common causes of pediatric and adolescent kyphosis?

    The most commonly observed kyphosis in children and adolescents is postural deformity caused by poor posture. Increased muscle strength and physical condition can be preventive.

  • What is Structural Kyphosis?

    Structural kyphosis is increased curvature of the back that is greater than 55 degrees, even when the person is in physiologic standing position. It is often due to an underlying bone and/or soft tissue pathology. It is generally known as Scheuermann's Kyphosis. 

  • What is the most common causes of structural kyphosis?

    The most common cause of structural kyphosis in growing patients are the idiopatic condition named as Scheuermann's disease. At least 4 adjacent vertebra are not in rectangular shape but wedged. If untreated it may be progressive.

  • What causes postural kyphosis and can it be prevented?

    The most common causes of postural kypohosis are having a poor posture and the lack of physical condition. Especially nowadays, children mostly spend their time in school- courses-computer triangle. Unfortunately, in mobile era children perform less sportive activities. These change of habits are the main causes of postural kyphosis.

  • How can postural kyphosis be corrected?

    To eliminate its underlying causes is the best way to prevent  postural kyphosis. 

    Teaching them how to obtain and maintain a good standing and sitting posture and encouraging them for exercises are at crucial importance. 

  • What is the correct position of sitting while studying?

    • One must lean on the high backrest on the chair, stretch arms forwards and move the chair close to the table instead of leaning forwards.
    • The monitor should be at eye level. The height of the chair should be set accordingly.
  • Which sports should be performed or avoided by patients with scoliosis?

    There is no evidence-based verification that any type of sports activity prevents, corrects, causes, or increases scoliosis. On the other hand, the development of sport activity habit and discipline is in fact necessary for all children, with or without scoliosis. It may be helpful if children with scoliosis are encouraged for sports because of the physical effects of sports. In addition, making a child with scoliosis participate in sports may be better than doing nothing and has no harm. Families should not have a high expectation for the control or correction of scoliosis. The type of sports is not very significant. What is significiant is that the child should choose a sports type which he/she will be interested in, constantly perform, and which will increase the physical condition. The sports should also be easily accessible.

    Some sports types, especially gymnastics, were claimed to be causing scoliosis. In a scientific study, the rate of scoliosis in children doing gymnastics were 10 times greater compared to children who did not. However the methodology of the study was severely criticized. Indeed, numerous newer studies showed that there was no relationship between sports and scoliosis. The higher incidence of scoliosis found in elite athletes doing gymnastics was explained as follows: elite gymnast children often have joint laxity and this is why these children become successful gymnasts. Scoliosis is thought to be more common in children with joint laxity.

    In conclusion, sports is a necessary habit that should be gained by children regardless of the purpose. We do not have sufficient data regarding that sports causes, prevents, or stops progression of scoliosis.­

  • Will I loose weight after my spinal stenosis surgery?

    Patients with spinal stenosis often have significantly decreased walking distance and mobility due leg and lower back pain. Obese patients with this condition often claim that their failure to lose weight, or their gain in weight, is due to the illness or the immobility caused by the illness.

  • Can the mattress affect back pain?

    A proper mattress enables a better sleep. Therefore, a patient will feel better in the morning, which may also positively affect the perception of pain during the day.

    It is thought that mattress type may have an effect on the discs between the vertebra.

  • Is this or that mattress better for spinal health?

    Hard mattresses can increase back pain and alter your sleep. Extra soft, worn-stringed, old and collapsed beds, on the other hand, also commonly cause back pain.

    There is no scientific data to define one single ideal type of mattress. 

    Medium firm mattress, independent coil string mattress or viscoelastic memory mattresses may be good choices for spinal health.

  • Is it necessary to wait until certain age or skeletal maturity for scoliosis surgery?

    Scoliosis surgery can be performed as early as 1-year-old, and also octo- or nonagenarians.

    The key is to choose the appropriate treatment method for different ages. 

  • Are there any ‘normal’ curvatures of the spine?

    The spine should be straight when looked from the back. When we look from the side, we see that the spine is not all straight. There is a slight concavity in our neck and lower back (lordosis), a slight gibbosity in our back (kyphosis).

  • Which signs are indicators of scoliosis?

    When looked from the back:

    • One shoulder being higher than the other. Asymmetry in shoulder levels. The left shoulder often being lower than the right.

    • Asymmetry in waist lines. One side being more fuller than the other. 

    • Sideways shifting of the trunk

    • A prominence on one side in the back, presence of gibbosity. The increase of this prominence with forward bending.

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