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medical condition in which a person's spine is curved from side to side. Although it is a complex threedimensional deformity, on an x-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line.
Scoliosis
is a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve seen from the side in which the spine is bent forward. Lordosis is a curve seen from the side in which the spine is bent backward. People with scoliosis develop additional curves to either side, and the bones of the spine twist on each other like a corkscrew.
There
are 3 other main types of scoliosis: Functional : the spine is normal, but
an abnormal curve develops because of a problem somewhere else in the body. This could be caused by one leg being shorter than the other or by muscle spasms in the back. Neuromuscular : there is a problem when the bones of the spine are formed. Either the bones of the spine fail to form completely, or they fail to separate from each other.
This type of scoliosis develops in people with other disorders including birth defects, muscular dystrophy, cerebral palsy, or Marfan's disease. If the curve is present at birth, it is called congenital. This type of scoliosis is often much more severe and needs more aggressive treatment than other forms of scoliosis.
scoliosis that are found in children and teens, degenerative scoliosis occurs in older adults. Caused by changes in the spine due to arthritis. Weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs can lead to an abnormal curvature of the spine. Others: There are other potential causes of scoliosis, including spine tumors such as osteoid osteoma. This is a benign tumor that can occur in the spine and cause pain. The pain causes people to lean to the opposite side to reduce the amount of pressure applied to the tumor.
may cause the head to appear off center or one hip or shoulder to be higher than the opposite side. If more severe, it can make it more difficult for the heart and lungs to work properly cause shortness of breath and chest pain
most cases, scoliosis is not painful, but there are certain types of scoliosis than can cause back pain.
In
use a medical and family history, physical exam, and tests when checking a person for scoliosis. An x ray of the spine can help the decide if a person has scoliosis. The x ray lets the measure the curve in degrees (such as 25 degrees) and see its location, shape, and pattern. Also may request an MRI scan.
Tests
Adams Bend Test
The person's age How much more he or she is likely to grow The degree and pattern of the curve The type of scoliosis
abnormality elsewhere in the body. this type of scoliosis is treated by treating that abnormality, such as a difference in leg length there is no direct treatment of the spine because the spine is normal in these people
scoliosis is caused by an
Neuromuscular
by an abnormal development of the bones of the spine. have the greatest chance for getting worse. observation and bracing do not normally work well Majority will eventually need surgery to stop the curve from getting worse.
scoliosis is caused
Idiopathic
age when it develops In many cases, infantile idiopathic scoliosis will improve without any treatment. X-rays can be obtained and measurements compared on future visits to determine if the curve is getting worse. Bracing is not normally effective Juvenile idiopathic scoliosis - has the highest risk for getting worse of all of the idiopathic types of scoliosis.
curve is not very severe. The goal is to prevent the curve from getting worse until the person stops growing. Since the curve starts early, and they have a lot of time left to grow, there is a higher chance for needing more aggressive treatment or surgery.
Adolescent
the most common form of scoliosis. If the curve is small when first diagnosed, it can be observed and followed with routine X-rays and measurements. If the curve stays
idiopathic scoliosis - is
below 25 degrees, no other treatment is needed. If the curve is between 25-40 degrees, a brace
may be recommended. If the curve is greater than 40 degrees, then surgery may be recommended.
Surgery: 1. to correct a curve or stop it from getting worse when the person is still growing 2. the curve is more than 45 degrees & the curve is getting worse. 3. often involves fusing together two or more bones in the spine, doctor may also put in a metal rod or other device. These devices are called implants. They stay in the body and help keep the spine straight after surgery.
Fusion
Most scoliosis operations involve fusing the vertebrae. The instruments and devices used to support the fusion vary. In the fusion procedure, the surgeon will: Slice flaps to expose the backs of the vertebrae that lie along the curve. Remove the bony outgrowths along the vertebrae that allow the spine to twist and bend. Lay matchstick-sized bone grafts vertically across the exposed surface of each vertebra, being careful that they touch adjoining vertebrae. Fold the flaps back to their original position, covering the bone grafts. These grafts will regenerate, grow into the bone, and fuse the vertebrae together.
This adolescent girl had a 50 curvature treated by thoracoscopic technique resulting in excellent correction. Note the spontaneous correction of the un-operated lumbar curvature. Also note the small, wellhidden incisions associated with the procedure.
treatment
stimulation supplements
Exercise
Pain relief Mechanical unloading Scoliosis management Spinal immobilization after surgery Spinal immobilization after traumatic injury Compression fracture management Kinesthetic reminder to avoid certain movements
Osteopenia
Skin breakdown Nerve compression Ingrown facial hair in men Muscle atrophy with prolonged use Decreased pulmonary capacity Increased energy expenditure with ambulation Difficulty with transfers Psychological and physical dependency Increased segmental motion at the ends of the Orthosis Unsightly appearance Poor patient compliance
scoliosis
is not typically associated with back pain. In cases with back pain, the symptoms can be lessened with physical therapy, massage, exercises, yoga. These can help to strengthen the muscles of the back. They are not, however, a cure for scoliosis and will not be able to correct the abnormal curve.
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