17/09/2026
Skolioza je deformacija hrbtenice, pri kateri se ta ukrivi v stran in hkrati zavrti okoli svoje osi, zato hrbtenica ne poteka več ravno, temveč tvori značilno krivino v obliki črke C ali S. Pogosto se pojavi v otroštvu ali mladostništvu, lahko pa tudi kasneje v življenju, pri bolnikih z Marfanovim sindromom pa je pogostejša zaradi prirojene slabosti vezivnega tkiva, ki daje oporo kostem in sklepom.
Poznamo več oblik skolioze. Najpogostejša je idiopatska skolioza, pri kateri natančnega vzroka ne poznamo in se običajno pojavi v obdobju rasti. Prirojena skolioza nastane zaradi nepravilnega razvoja vretenc že pred rojstvom. Nevromišična skolioza je povezana z boleznimi živčevja in mišic, kot so cerebralna paraliza ali mišične distrofije. Degenerativna skolioza se razvije pri odraslih zaradi obrabe hrbtenice, diskov in sklepov. Pri Marfanovem sindromu se skolioza pogosto uvršča med sindromske oblike, kjer je del širše genetske bolezni.
Zdravljenje skolioze je odvisno od stopnje ukrivljenosti, starosti bolnika in napredovanja deformacije. Pri blagih oblikah, kjer je ukrivljenost majhna in ne napreduje, zadostujejo redni pregledi in spremljanje. Fizioterapija in posebne vaje se uporabljajo za krepitev mišic, izboljšanje drže in zmanjševanje bolečin, vendar same po sebi običajno ne morejo popraviti ukrivljenosti. Pri zmernih oblikah, zlasti pri otrocih in mladostnikih, se pogosto uporablja steznik, ki pomaga upočasniti ali preprečiti nadaljnje krivljenje hrbtenice v času rasti.
Operacija skolioze je potrebna pri hudih oblikah, ko je ukrivljenost velika, hitro napreduje ali povzroča bolečine, motnje dihanja ali težave pri delovanju notranjih organov. Med operacijo kirurg poravna hrbtenico v čim bolj normalen položaj in jo stabilizira s kovinskimi palicami, vijaki in drugimi vsadki. Pogosto se izvede tudi zatrditev oziroma zraščanje vretenc, da se prepreči ponovna ukrivitev. Po operaciji sledi rehabilitacija, ki vključuje postopno vračanje k gibanju in krepitev mišic. Pri bolnikih z Marfanovim sindromom je potrebna posebna previdnost, saj imajo zaradi vezivnotkivne motnje večje tveganje za zaplete in počasnejše celjenje.
Patients with Marfan syndrome often have a curvature of the spine, known as scoliosis. Scoliosis is a deformity of the spine in which it curves sideways and at the same time rotates around its own axis, so the spine no longer runs straight but forms a characteristic C- or S-shaped curve. It most commonly appears in childhood or adolescence, but it can also develop later in life. In patients with Marfan syndrome, scoliosis is more frequent because of the congenital weakness of connective tissue, which provides support to bones and joints.
There are several types of scoliosis. The most common is idiopathic scoliosis, where the exact cause is unknown and it usually develops during the growth period. Congenital scoliosis arises from abnormal development of the vertebrae before birth. Neuromuscular scoliosis is associated with diseases of the nervous system and muscles, such as cerebral palsy or muscular dystrophy. Degenerative scoliosis develops in adults as a result of wear and tear of the spine, intervertebral discs, and joints. In Marfan syndrome, scoliosis is often classified as a syndromic form, meaning it is part of a broader genetic disorder.
Treatment of scoliosis depends on the degree of curvature, the patient’s age, and the progression of the deformity. In mild cases, where the curvature is small and does not progress, regular monitoring and follow-up examinations are sufficient. Physiotherapy and specific exercises are used to strengthen muscles, improve posture, and reduce pain, but on their own they usually cannot correct the curvature. In moderate cases, especially in children and adolescents, a brace is often used to slow down or prevent further progression of the spinal curvature during growth.
Surgical treatment of scoliosis is necessary in severe cases, when the curvature is large, rapidly progressing, or causes pain, breathing problems, or disturbances in the function of internal organs. During surgery, the surgeon straightens the spine as much as possible and stabilizes it with metal rods, screws, and other implants. Spinal fusion is often performed to prevent the curve from returning. After surgery, rehabilitation follows, including gradual return to movement and muscle strengthening. In patients with Marfan syndrome, special caution is required because their connective tissue disorder increases the risk of complications and slower healing.