Scoliosis: a lateral curvature of the vertebral
column., scoliosis may occur in the thoracic, lumbar, or thoracolumbar
spinal segment. The curve may be convex to the right ( more common
in lumbar curves ) or to the left ( more common lumbar curves) Rotation
of the vertebral column around its axis occurs and may cause rib cage deformity.
There are two different types of scoliosis; functional (postural
) ,and structural . They are both associated with kyphosis
( humpback ) and
lordosis
( swayback ). Scoliosis usually affects adolescent girls. Most school
now check adolescents for scoliosis, check with your school district if
your interested.
Functional Scoliosis: it is a results from poor
posture or a discrepancy in leg lengths.
Structural Scoliosis: it involves deformity of the vertebral
bodies. It may be congenital ( present at and existing from
the time of birth ) such as wedge vertebrae, fused ribs or vertebrae, or
hemivertebrae. Paralytic ( affected with paralysis ) such
as polio, cerebral palsy, or muscular dystrophy, or idiopathic (
occurring without known cause ), the most common form, may be transmitted
as an autosomal dominant ( a non – sex- determining chromosome )
or multifactorial trait, it appears in a previously straight spine during
the growing years.
Symptoms:
Curving of the spine ( usually in the thoracic segment ), with convexity
to the right (having a rounded, somewhat elevated surface ), and
compensatory curves ( S curves ) in the cervical segment above and the
lumbar segment below, both with convexity to the left.
Backache
Fatigue
Dyspnea ( difficulty breathing )
Unequal shoulder heights, elbow levels, and heights of the iliac crests.
Your doctor may want to take an X-ray of your spine
Treatment:
The most effective treatment should begin very early, when spinal deformity
is still subtle.
Your doctor will determine what course of therapy and or treatment
depending on the severity of the deformity.
A brace may have to worn (Milwaukee brace )
Surgery may be needed
Close observation and exercise
A mild curve ( less than 25 degrees ) can be monitored by X -Rays and
an examination by your doctor every 3 months. Along with exercise program
to strengthen the turso muscles and help prevent curve progression.
A heel lift may help.
A curve of 25 degrees to 40 degrees requires spinal exercises and a
brace. Your doctor may prescribe you to undergo transcutaneous electrical
nerve stimulation ( TENS ). A brace helps to halt progression in
most patients but does not reverse established curvature.
A curve of 40 degrees or more requires surgery ( spinal fusion ), since
a lateral curve progresses at the rate of 1 degree a year even after skeletal
maturity.
* Early detection is the Key. See your doctor if you suspect
and or have any of the symptoms above.
* If the patient have a brace, keep in mind: Do not insert
anything or let anything get under the cast and to immediately report cracks
in the cast, and if there is pain, swelling, skin breakdown, and
numbness see your doctor Promptly.
Cast Syndrome: a serious complication, this syndrome
may follow spinal surgery and application of a body cast.
The patient may experience nausea, abdominal pressure, and vague abdominal
pain. Experts believe the reason for cast syndrome is probably due
to hypertension of the spine. Hypertension of the spine accentuates lumbar
lordosis, with compression of the third portion of the duodenum between
the superior mesenteric artery anteriorly, and the aorta and vertebral
column posteriorly. High intestinal obstruction produces nausea,
vomiting, and ischemic infraction of the mesentery.
Untreated cast syndrome may be fatal. * Call your doctor immediately,
this syndrome may develop as late as several weeks or months after application
of the cast.