“The spine is one of the most complex and important parts of the human body, and spinal complaints and conditions can severely affect a person’s general health and quality of life.”
Spinal surgery requires close collaboration between various disciplines, in particular orthopedists and brain surgeons. Congenital progressive spinal deformities, injuries and other severe conditions are treated by trained physicians, surgeons and specialists in physical treatment.
Yeditepe University Hospital’s Spine Clinic offers the very highest level of health care and preventive health measures within our multidisciplinary philosophy.
Yeditepe believes that each and every international patient in our Spine Clinic should receive the full benefit of Yeditepe University Hospital’s comprehensive range of medical expertise, across the spectrum of medical specialties.
The Yeditepe Hospital Spine Clinic brings together highly experienced and accomplished specialists in neurosurgery, orthopedic surgery, neurology, psychiatry and other specialties to design the most effective treatment for your condition.
The team includes experts in cancer, pain management, physical therapy, radiation oncology and rheumatology.
Specialists in neurosurgery, orthopedic surgery, medical spine and pain management collaborate - diagnosing and treating a variety of spine conditions, some of which are detailed below.
Major Conditions treated at the Yeditepe University Hospital Spine Clinic
- Scoliosis: When looked at from the side, the anatomy of normal people shows a certain degree of curvature. For example our backs have an outward curvature while our necks and waists curve inwards. But when looked at from the front – rear plane our spines are straight and do not bend. Scoliosis is the condition in which our spine has a sideways S- or C- curve; this abnormal curvature may cause scoliosis patients to have shoulder asymmetry, rib hump, trunk shift, and asymmetry in the curve of the waist. Scoliosis is not a diagnosis but a descriptive term. The cause is unknown in 80% of cases and this type is classified as “Idiopathic scoliosis.” It occurs most often during the growth spurt just before puberty. Other types include Congenital Scoliosis (caused by vertebral anomalies present at birth), Neuromuscular Scoliosis (the result of a neuromuscular condition such as spina bifida, cerebral palsy, spinal muscular atrophy, or physical trauma), or Syndromic Scoliosis (related to various medically defined syndromes).
- Kyphosis: When looked at from the side, the anatomy of normal people shows a certain degree of curvature. For example our backs have an outward curvature while our necks and waists curve inwards. An increased physiologic rounding of the upper back or abnormal rounding in the neck or waist regions is normally pathologic. The most common type, mainly seen in male adolescence, is Scheuermann's Kyphosis. Other types include Congenital Kyphosis related to spinal failures at birth, Post-traumatic Kyphosis related to inadequate treatment following a physical trauma, and Post-laminectomy Kyphosis related to surgical procedures carried out to treat cervical myelopathy.
- Curvature of the Spine (Developmental Spondylolisthesis): Spondylolisthesis is the term given to the forward translation of one vertebral segment over the one beneath it. The integrity of the bone can be compromised when growth during childhood involves a break in a part of a vertebra called the pars interarticularis. Roughly translated, that means "the part between two joints." A defect in the pars is a break in this portion of bone. This break leads to a separation of the upper, front portion of the vertebra from its lower, back portion. This condition may be a precursor to Developmental Spondylolisthesis. It generally occurs as a result of repetitive trauma after the age of 8 years. Both conditions cause severe back pain and spasms. In some cases it can even lead to scoliosis.
- Diagnosis: Spinal / vertebral fractures in healthy non-osteoporosis cases can be the result of high energy traumas such as traffic accidents or falls. Partial or total paralysis can result from compression of the spinal cord.
- Treatment: If the trauma is unlikely to result in subsequent deformity and there is no neurologic evidence of nerve compression, treatment may be given by means of a corset. Rigid polyethylene corsets or metal frame corsets may be used for this purpose. In cases of more severe spinal damage, it may be necessary to fix and stabilize the spine by means of pins or screws, in order to prevent future deformity. In the event of neurologic findings of bone pressure, this pressure may be removed during the same surgical session.
Ageing vertebrae and Osteoporosis
- Osteoporotic Vertebral Fractures: as one gets older, and / or with menopausal changes, osteoporosis can cause a reduction in bone mass. This condition can result in bone fractures even as a result of minor injury or knocks. The most frequently broken bones are the vertebrae and the hips. In very severe cases of osteoporosis, even sneezing can cause bone fracture. The most common symptom is back and lower back pain. In some cases, the patient may not be severely disturbed by the pain caused by a fracture but will only consult his or her physician as a consequence of the deformity that is causedby the fracture.
- Kyphosis in the elderly: As one gets older, kyphosis can develop as a result both of osteoporotic fractures and disc degeneration. In these cases, respiratory difficulties can arise and the patient’s daily activities may be affected.
- Scoliosis in the elderly: As one gets older, scoliosis may be caused by degenerative spinal conditions as well as an increasing severity of pre-existing scoliosis. The former case is frequently associated with increasing leg pain caused by pressure on the nerves.
Degenerative Spinal Conditions
- Herniated Disc: The intervertebral disc is the name given to the joint between each vertebrae. A herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine. A spinal disk has a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer "jelly" pushes out through a crack in the tougher exterior. A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. On the other hand, many people experience no symptoms from a herniated disk. Most people who have a herniated disk don't need surgery to correct the problem, but surgical intervention is required when the pain persists or in the event of neurologic loss.
- Spinal Stenosis (Narrowing of the spinal canal): Spinal stenosis is a narrowing of the open spaces within the spine, which can put pressure on your spinal cord and the nerves that travel through the spine. Spinal stenosis occurs most often in the neck and lower back. Spinal stenosis can cause pain, numbness, muscle weakness, and problems with bladder or bowel function. It is most commonly caused by wear-and-tear changes in the spine related to aging. In severe cases of spinal stenosis, doctors may recommend surgery to create additional space for the spinal cord or nerves.
- Diagnosis: Spinal tumors may be benign or malignant. Benign tumors (generally encountered during adolescence) can cause pain; they generally originate in the bone and are called osteoid osteoma or osteoblastoma. Tumors in the body tissue or organs most frequently spread to the spine. For this reason, in the event that a malignant tumor is identified in the spine, there is a high possibility that this originates in another part of the body.
- Treatment: Tissue diagnosis is very important in terms of the approach that should be taken. Therefore, if the origin of the tumor is unknown, or if the tumor originates in the spine, a biopsy must first be taken. Following that determination, chemotherapy, radiotherapy, surgery or a combination of these treatments will be followed according to the type of tumor.
- Tuberculosis (TB): This is the most frequent effect of spinal infections in less developed and developing countries. Kyphosis of the spine may be caused by spinal degeneration. TB responds well to medical treatment when it is diagnosed early. Surgery may be required in cases where there is abscess development, permanent pain, deformity, or other neurologic findings.
- Non-specific Infections: Secondary infections in the spine can occur especially in the event of urinary infection when the bacteria spread through the bloodstream to the spinal region. The treatment strategy is similar.
The goals of scoliosis surgery are threefold:
- Straighten the spine as much as possible in a safe manner
- Balance the torso and pelvic areas
- Maintain the correction long-term
It takes a two-part process to accomplish these goals:
- Fusing (joining together) the vertebrae along the curve
- Supporting these fused bones with instrumentation (steel rods, hooks, and other devices) attached to the spine
Yeditepe University Hospital’s specialist team is fully equipped with the latest technology and medical techniques to be able to conduct scoliosis surgery with high rates of success. While there are many surgical variations that use different instruments, procedures, and surgical approaches to treat scoliosis, they all require meticulous skill. In most cases, success depends less on the type of operation than on the skill and experience of the surgeon.
The cause of scoliosis often determines the type of procedure. Other determinants include the location of the curve (thoracic, thoracolumbar, or lumbar); single, double, or triple curves, and any rotation that may be present; and how large the curve is.
At Yeditepe University Hospital, we are aware that being treated away from your home country can be a challenging experience. Parents of patients or adult patients should not be shy in asking our physicians and our International Office about their experience and advice concerning the specific procedures being considered.