Spinal Health Center

At Memorial Spinal Health and Surgery Centre, diagnosis and treatment of all kinds of spinal diseases seen in children and adults are realized successfully. At Memorial Spinal Health and Surgery Centre, modern treatments are made with superior technological hardware and experienced physician team, scoliosis, kyphosis, spinal disc herniation, spinal infections and tumors, spinal fractures, lumbar and neck pains are treated.

At Memorial Spinal Health and Surgery Centre, treatments are carried out in a multidisciplinary approach. Diagnosis and treatment of patients are realized by a committee formed by orthopedics, neurosurgery, radiology, anaesthesiology, psychology, neurology and physical therapy specialists.

Features of Spinal Center that come to the forefront

• Full and complete expertise in spinal and spine diseases and surgery.
• All treatment methods’ including surgery being at the forefront and their being multidisciplinary.
• Patient’s and patient rights’ being the focus of all types of diagnosis and treatments. We guarantee not to make unethical applications to our patients.

Operations that are realized at our center

1. Revision surgery

   1. Patients requiring revision due to mechanical problems
   2. Patients requiring revision due to complications
   3. Patients requiring revision due to infections
   4. Patients requiring revision due to growth or aging problems which develop in time

2. Complex deformity surgery

   1. Scoliosis or kyphosis commencing at early childhood and having high angular deformities
   2. Scoliosis or kyphosis with spinal adhesions or other birth anomalies
   3. Advanced and complex deformities coming out due to trauma, previous surgery, etc.
   4. Deformities related to muscle diseases and other neurological reasons

3. Surgery of spinal tumors and lesions

   1. Spinal tumors
   2. Spinal adhesions, Arnold Chiari syndrome
   3. Spinal cysts

4. Surgery of spinal tumors

   1. Tumors of spinal bones, osteosarcome, Ewing sarcoma, plasmocytoma
   2. Metastatic tumors of spine, breast, prostate, thyroid etc.
   3. Sacrum tumors (chordoma etc)

5. Minimal invasive spinal surgery

   1. Percutaneous instrumentation for spinal fractures
   2. Minimal invasive decompression and instrumentation for channel stiffness
   3. Minimal invasive waist and neck disc herniation surgery
   4. Vertebroplasty/Kyphoplasty

6. Standard applications of spinal surgery

   1. Low back and neck pain and herniations
   2. Spinal trauma, fractures
   3. All deformities of the spine
   4. Tuberculosis and other spinal infections
   5. All other spinal operations

SCOLIOSIS (ADOLESCENT IDIOPATHIC SCOLIOSIS)

What is Scoliosis?

Scoliosis is a spinal shape disorder which can be defined as bending of spine to the right or to the left in an unhealthy way. When it is looked from the side, spine of a normal person, certain depressions at the neck and waist areas (lordosis) and a hump at the back area (kyphosis) are acceptable. But when it is looked from the front or from the back, there should be no curvature at the spine. If there is, it is a situation to be investigated. Regarding scoliosis, which is usually diagnosed during childhood period, small degree of curvatures may not be recognized during childhood and they can also be diagnosed during adult period.

In what situations should families suspect from scoliosis?

1. If there is asymmetry at the waist or back of the child
2. If one of his shoulders is higher than the other one
3. When looked from behind, if blade bone is more prominent or specific
4. If it looks as if one leg is longer than the other one
5. If the body or chest cage looks like it has shifted to one side
6. When the child bends forward, if ribs on one side of the body remain higher than the other side
7. If the cloths of child look asymmetrical as he wears them, it can be suspected that there is spinal shape disorder.

HERNIATED DISC SURGERY

Under which conditions and to whom it is applied

There are three major problems which patient and physician can be confronted with relating to herniated discs.

1. Severe pain spreading through the leg
2. Loss of sensation and/or strength at various degrees of severity
3. Loss of control of urine and stool

When problems are listed in this way, the answer to the question about which patients to be provided with surgical intervention comes out automatically:

Pain: It is not considered as a surgical indication by itself. Studies being conducted in this subject reveal that whether patients have surgery after 2^nd month or not, they have same level of pain. On the other hand it is known that for eliminating very severe acute pain of patients, surgery is a more effective method. In this situation surgical indication regarding the pain is more related with how much patient can tolerate the pain. Still we can mention that most frequent reason of surgery is pain.

Loss of sense and strength: If it is progressing, it is considered that there is an absolute reason for surgery and if it is not progressing and even diminishing, it is considered that there is an ambiguous reason for surgery. Even though we, as physicians, think that diminishing the pressure on the nerves has positive impact of recovery process, there are no clinic evidences with 100% precision. Still it is a fact that it is a frequently seen reason for surgery.

Loss of urine/spool control: It is an ABSOLUTE and URGENT reason for surgery. There are evidences that if it is permitted for loss of control of patients in these situations to continue for long time, negative outcomes can be observed later on.

How is it applied?

Golden standard of herniated disc surgery is generally accepted as microscobic discectomy. Realizing surgery under microscobic enlargement both enables reliance (while reducing the probability of damaging other tissues) and reduction of wound and tissue size of patient  and the recovery process to be accelerated. Discectomy with microscobe is applied by making an opening with a small cut or with assistance by tubes.

KYPHOSIS (HUMP BACK) AND ITS SURGERY

Under what conditions and to whom is it applied?

Since kyphosis creates a more severe problem when it turns into a disease, with respect to scoliosis, it is a problem which we take very seriously.

As you know, in fact there is certain amount of kyphosis at the back of all of us. But when this kyphosis gets increased, we name this situation as a disease. But why is it important? There are two main reasons for that:

1. Kyphosis incidents that start at early childhood period can cause lung and heart problems at severe degrees that can not be compared with scoliosis cases. 
2. Kyphosis which come out at older ages, can be painful starting from the beginning and they can disrupt life quality seriously both due to the pain they cause and the reduction of capacity of the lungs.

Kyphosis is not a dangerous disease only in small children but also in elderly people. If we compare it with scoliosis, although scoliosis is a matter which is known better and followed up more, in fact if there is no kyphosis incident accompanying it, it does not cause a real health problem and kyphosis can cause life danger alone by itself.

SPINAL INFECTIONS AND TUMORS

Who should have surgery?

Regarding this subject there are three main surgical reasons:

• Eliminating infection or tumor from the body
• Treating partial or complete paralysis occurring due to infection or tumor
• Eliminating instability occurring as a result of this surgery or due to tumor or infection itself (for explanation please look at the section relating with fractures).

SPINAL FRACTURES

Who should have surgery?

There are two main surgical reasons for spinal injuries:

1. Patient’s having partial or complete paralysis as a result of getting injured: Especially in cases of partial paralysis and in cases when it is found out that paralysis incident is progressing, it is required to provide surgery in an ABSOLUTE and URGENT way. These patients benefit a lot from operations providing nerve tissue relaxation which are provided at the soonest time and in most of them complete or near complete recovery is being achieved. Especially in complete paralysis incidents occurring as a result of fractures seen in the neck section, it is not expected for this situation to be corrected by surgery. Still, even taking the level of paralysis one or two discs below can provide serious benefits and therefore, URGENT surgery is recommended even if not being as absolute and urgent as the other ones.
2. Spine’s losing its capacity to carry the body with or without the incident of paralysis: We call this situation as instability. For example if main bone of your leg gets broken and even though you don’t have paralysis for this reason, it can not be possible for you to give load on this leg (pain and mechanic insufficiency), and it is required for this fracture to be cured, similarly a situation occurring at the spine can necessitate repair (stabilization).

LOW BACK AND NECK PAIN

Low back pain is defined as one of the most important reasons causing functional failure in developed countries and it is especially seen in industrial segment and productive segment of community. Low back pain is one of the most important health problems causing suffering of the person as well as loss of labor force. Especially in the ranking of chronic diseases which are seen in developed countries, it is ranked in second row following heart diseases.

If complaint from low back pain is for a period that is shorter than 6 weeks it is defined as acute low back pain and pains continuing for more than 6 weeks are defined as chronic low back pain.  Acute low back pain can come out as a result of any kind of activity or accident and it can also occur due to an unknown reason. Nearly 80% of these patients can completely recover without requiring any treatment within 6 weeks after the first incident. On the other hand nearly 30% of patients experiencing acute low back pain are candidates for having repeated low back pains and they don’t experience chronic pain.

Pain that continues for more than 3 months is defined as chronic low back pain. Continuing pain occurs as a result of tissue irritation and stimulation of nerve endings as a result of inflammation caused by the.

Among the main reasons of low back pain, forcing low back section, posture (standing) disorders, injuries (muscle, connective tissue and ligament injuries, spine and spinal injuries), herniated disc, disruption of disc (degenerative disc disease), waist shift, constriction of spinal canal, calcification of joints formed by vertebral bones, sacroiliitis, inflammatory diseases that are similar to ankylosing spondylitis, infection at disc and/or vertebral bones and surrounding tissues (discitis, osteomyelitis etc), pains occurring after previously implemented surgeries which could not be cured (unsuccessful low back surgery disease), tumors, birth anomalies, bone thinning (osteoporosis) and psychogenic low back pain.

Situations accompanying low back pain for which advanced examinations are absolutely required;

• Night pain
• Cancer story
• Menopause, osteoporosis
• Having the need to move continuously while being seated
• Loss of weight that can not be explained
• High fever, tiredness, weakness, diarrhea, nausea, night sweltering
• Weakness on legs or bladder/bowel function disorder
• Pain which starts secretly and which gets intense in time
• Sacral pain without any history of trauma (at the hip, tail end)
• Pain that does not decrease with resting in bed
• Pain that does not change with movement and physical activity
• Low back pain that increases while bending forward and standing up on feet
• Low back pain which is accompanied with spread joint pain and morning malfunction
• Low back surgery being had
• Tuberculosis, rheumatismal disease story

Neck pain

Neck pain is the musculoskeletal system complaint which is observed with secondary level of frequency following low back pain. In recent years as computers, tablets and smart phones came into our lives as essential particulars, neck pain complaint and its frequency is increasing.Within adult age group half of people have experienced neck pain incident at least once in their lives.
While back pain and restrictions in neck movements can accompany neck pain from time to time, it should also be kept in mind that it can also cause headache. Frequently mechanic neck pains are seen that occur as a result of neck muscles’ and connective tissues’ being effected from trauma or from bad posture. Apart from these cervical disc hernia can develop due to spinal diseases occurring with degeneration of neck vertebra, narrowing of spine canal, and with the entrapment of nerves and spine. Although mechanical neck pains get migrated within a few days and are completely eliminated within 1-2 weeks time, sometimes they can become chronic and they can get intensified with attack incidents. Incidents where neck pain increases instead of being diminished, especially being accompanied with pain that spreads through the arms, development of loss of strength and/or sensing on the arms, occurrence of intense sensitivity on bone structure, having an injury story in the past, presence of diseases such as cancer and rheumatismal diseases in the patient that could cause systematic involvements, high fever accompanying the pain, and loss of weight necessitates for the pain to be considered seriously and for detailed evaluation to be made.

Situations accompanying neck pain for which advanced examinations should absolutely be made;

• Story of injury or spinal surgery
• Systematic findings, loss of weight, high fever, night sweetening ,
• Intense pain
• Night pain
• Age <20, >45
• Apparent sensitivity on the neck
• Spinal cord compression findings
• Tuberculosis, AIDS, rheumatismal diseases
• Cancer story