SCOLIOSIS.
The straight facts on scoliosis.
Sports physicals are upon most parents and kids this time of year. Often, these
annual or biannual examinations are the only time young healthy children and
teenagers need to visit a health professional. During these health examinations,
a physician also screens the student athlete for scoliosis, and if detected,
recommend treatment. Similar scoliosis screenings have been offered to families
in area schools as a preventative measure.
Scoliosis is a fairly common problem that can be corrected. Let's look a little
more closely at this correctable condition.
What is scoliosis? Scoliosis is a curvature of the
spine. Instead of the spine being in a straight line, it is bent from side to
side. The bones of the back
are called the vertebrae. The neck bones are called cervical vertebrae and the
midback bones are the thoracic vertebrae. The "small of the back" vertebrae
compose the lumbar spine. All of these bones should stack upon each other in
a straight line. Normal curves of the spine will be forward and back.
With scoliosis, the most commonly involved area is the thoracic spine. It is
obvious to see these bones to be aligned and bent in a sideways fashion. There
are 12 thoracic vertebrae, so this involves a fairly large area. The bones of
the "small of the back" are rarely involved, as are the neck bones.
What causes Scoliosis? There are many causes for scoliosis,
but 80-85% of the cases are called idiopathic. This means that there is no known
cause and it just
happens. Usually, scoliosis will develop gradually over time and is more pronounced
as a child develops. That is why the sports physical may be the first time that
this condition is detected. Sometimes, parents may notice a change in their child's
posture and alert their health care provider to the condition.
Nonstructural or functional scoliosis is seen when the normal spine appears curved
and the condition may be temporary. The temporary causes may be due to a muscle
spasm or a shortened leg. Once the temporary cause is corrected, the spine returns
to its normal configuration.
Structural scoliosis is when the spine is fixed in an abnormal curve. There is
usually an underlying medical problem that may be caused by a tissue disorder,
arthritis, cerebral palsy, polio, birth defect, or tumor. But, it is important
to remember that a majority of these cases have no known cause.
What are the symptoms? Usually, a child or teenager
may have no complaints of pain, but just a noticeable deformity. The shoulders
may seem uneven or a shoulder
blade may be sticking out. There may be an obvious curve in the back or a hump.
Eventually, it may be noticeable that the person is leaning to one side and this
may lead to back pain.
How is it diagnosed? A health care provider makes
diagnosis on the basis of the history and physical examination. The spine may
be x-rayed to evaluate the spine
in a more precise manner. Usually, the sports physical is a time when this screening
may occur.
Who is at risk? Usually girls are affected more commonly
than boys. Young children with scoliosis will magnify the curve as they grow.
Lastly, children that are
born with a spinal abnormality are at increased risk for problems as they grow.
What is the treatment? Initially, the diagnosis must
be made and then the progression must be watched. Many children will outgrow
this, but it must be closely observed.
Early diagnosis leads to a better outcome if more aggressive therapy is necessary.
Checkups are usually recommended every 3-6 months.
Initial medical treatment may involve the wearing of a brace. One of the most
common braces is called the Milwaukee brace, which helps stop the progression
of the curve. This is the only option during the growing years and it essential
that it is worn prior to the cessation of the growth spurt. This is a fairly
successful method of treatment.
If bracing does not stop the development of the curve or the scoliosis is caught
too late, surgery may be necessary. The surgical procedure may involve the placement
of a rod in the spine to stop the curve from worsening. Sometimes, the vertebrae
are fused together as well. Some nonconventional treatments methods have no proven
success in the medical literature. Be careful to stick with proven medical and
surgical methods.
