Turkish hospital gets FDA approval in scoliosis therapy


The Emsey Hospital became Turkey's first health institution to get American Food and Drug Administration (FDA) approval in the orthopedics therapy field. The hospital received approval for its Flexible Scoliosis Therapy with scoliosis stretching method or non-fusion scoliosis surgery.

The hospital started performing the method two years ago with successful results and their method was approved as an effective treatment method in scoliosis by the FDA.

Scoliosis, colloquially called abnormal spinal curvature greater than 10 degrees, is usually more common in children and it worsens in pregnancy.

Stating that scoliosis is the asymmetry of the body on an anteroposterior projection and the abnormal curvature is recognized by patients and families, professor of Orthopedics and Traumatology Dr. Mehmet Aydoğan, the head of Advanced Spine Surgery Unit at Emsey Hospital, emphasized that the underlying causes of scoliosis may vary.

Intrauterine factors, such as muscle disorders or nervous diseases, account for 15% of all scoliosis cases. Around 85% of scoliosis cases are idiopathic. When the age at onset of the disease is considered, early-onset scoliosis implies the patients younger than 10, while late-onset scoliosis refers to conditions that begin after 10. The most common type is idiopathic scoliosis in adolescents. The condition is diagnosed at the age of nine to 11 years in girls and 12 to 14 years in boys. The abnormal curvature is recognized when the back of the patient is inspected; abnormal curvature in the lumbar area of the spine requires more careful examination.

Parents recognize shoulder asymmetry, prominent scapula and an elevated or prominent hip at one side of the body. The distance from hands to trunk is not equal at right and left sides of the body. Scoliosis should be considered and a physician should be visited, when ribs of ones hemithorax appear elevated relative to the other side while the child is bending frontwards by 10 degrees.

Aydoğan said that Non-fusion Scoliosis Surgery has been performed with very successful outcomes. Stating that physical exams are first step in the diagnosis of scoliosis, Dr. Aydoğan says, "After examination findings are reviewed, an x-ray is done on the anteroposterior and lateral projections while the patient is standing up. Patients should stand as erect as possible, knees should be straight and feet should be adjacent to each other while images are acquired. If length of legs is unequal, the shorter leg can be aligned with a support. For patients who cannot stand still, X-ray can be scanned at seated position without support. Lateral flexion views are acquired only for preoperative evaluation of flexibility. Such radiograms also help determine the severity of fusion."

"Non-fusion surgery has been performed for several years in our country and it enables correction of the abnormal curvature without any need to fuse the vertebras; the curvature is further corrected gradually, as the patient grows. In brief, non-fusion surgery eliminates certain advantages of the fusion technique, such as immobility and cessation of growth. This technique does not hinder the growth of children. The limitations caused by fusion surgery are completely eliminated by non-fusion scoliosis surgery. Three small incisions are made in the armpit and screws are driven to the spine with thoracoscopic technique; next, anterior surface of the spine is stretched with a thread and the curvature is corrected. This surgery is associated with less bleeding, fewer surgical incisions and milder pain as well as further correction of the curvature as the person grows," he said.