WHAT IS SCOLIOSIS ? PRESENTATION BY BEENA SHIBU SCOLIOSIS 1 WHAT IS SCOLIOSIS ? Scoliosis is an abnormal curve of the spine Your spine is your backbone It runs down your back with slight natural curve.
SCOLIOSIS PRESENTATION BY BEENA SHIBU WHAT IS SCOLIOSIS ? •Scoliosis is an abnormal curve of the spine •Your spine is your backbone •It runs down your back with slight natural curves •But people with scoliosis have a spine that curves too much •Their spine might look like the letter “C” or “S.” Scoliosis THERE ARE NATURAL CURVES IN THE NORMAL SPINE TYPES OF SCOLIOSIS •CONGENITAL SCOLIOSIS: CAUSED BY A BONE ABNORMALITY PRESENT AT BIRTH NEUROMUSCULAR SCOLIOSIS: A RESULT OF ABNORMAL MUSCLES OR NERVES DUE TO SPINA BIFIDA (BACKBONE / SPINAL CORD DO NOT CLOSE BEFORE BIRTH) •DEGENERATIVE SCOLIOSIS: THIS MAY RESULT FROM TRAUMATIC (FROM AN INJURY OR ILLNESS) BONE COLLAPSE, PREVIOUS MAJOR BACK SURGERY, OR OSTEOPOROSIS (THINING OF THE BONES) •IDIOPATHIC SCOLIOSIS: THE MOST COMMON TYPE OF SCOLIOSIS, IDIOPATHIC SCOLIOSIS, HAS NO SPECIFIC IDENTIFIABLE CAUSE THERE IS EVIDENCE THAT IDIOPATHIC SCOLIOSIS IS INHERITED •IDIOPATHIC SCOLIOSIS IS GROUPED BY AGE •IN CHILDREN AGE AND YOUNGER, IT IS CALLED INFANTILE SCOLIOSIS •IN KIDS AGE - 10, IT IS CALLED JUVENILE SCOLIOSIS •IN OLDER KIDS AGE 11 - 18, IT IS CALLED ADOLESCENT SCOLIOSIS •SCOLIOSIS MOST OFTEN AFFECTS GIRLS SIGNS & SYMPTOMS USUALLY THERE ARE NO SYMPTOMS BUT SYMPTOMS CAN INCLUDE: BACKACHE OR LOW-BACK PAIN TIRED FEELING IN THE SPINE AFTER SITTING OR STANDING FOR A LONG TIME UNEVEN HIPS OR SHOULDERS (ONE SHOULDER MAY BE HIGHER THAN THE OTHER) SPINE CURVES MORE TO ONE SIDE • • • • SIGNS AND TESTS IT IS VERY HARD TO DETECT SCOLIOSIS IN THE EARLY STAGES Physical Examination Adam's Forward Bend Test The screening test used most often in schools and in the offices of pediatricians and primary care doctors is called the Adam's forward bend test FORWARD BEND TEST THE CHILD BENDS FORWARD DANGLING THE ARMS, WITH THE FEET TOGETHER AND KNEES STRAIGHT IN A CHILD WITH SCOLIOSIS, THE EXAMINER MAY OBSERVE AN IMBALANCED RIB CAGE, WITH ONE SIDE BEING HIGHER THAN THE OTHER, OR OTHER DEFORMITIES TESTS TO DETECT SCOLIOSIS Magnetic Resonance Imaging Magnetic resonance imaging (MRI) is an advanced imaging procedure that does not use radiation, as x-rays It is expensive, however, and not generally used for an initial diagnosis MRI can, nevertheless, identify spinal cord and brain stem abnormalities TESTS TO DETECT SCOLIOSIS Three-Dimensional Modeling Techniques Advanced computer modeling techniques are able to create three dimensional images using x-rays or other twodimensional images They allow doctors to observe the spinal distortions and help to reduce the number of x-rays needed to monitor scoliosis and help surgeons determine the best surgical procedures DETERMINING THE DEGREE Cobb Method: •THE TECHNIQUE KNOWN AS THE COBB METHOD NEARLY ALWAYS CALCULATES THE DEGREE OF THE CURVE ON AN X-RAY OF THE SPINE, THE EXAMINER DRAWS TWO LINES: ONE LINE EXTENDS OUT AND UP FROM THE EDGE OF THE TOP VERTEBRAE OF THE CURVE THE SECOND LINE EXTENDS OUT AND DOWN FROM THE BOTTOM VERTEBRAE THE TECHNICIAN THEN DRAWS A PERPENDICULAR LINE BETWEEN THE TWO LINES MEASURING THE INTERSECTING ANGLE DETERMINES THE DEGREE OF CURVATURE • • • TREATMENTS •BRACE : The brace works by exerting pressure on the back and ribs to push the spine in a straighter position BRACING IS THE USUAL TREATMENT CHOICE FOR ADOLESCENTS WHO CURVE BETWEEN 25 DEGREES TO 40 DEGREES -MATURING AND IF THEY HAVE AT HAVE A SPINAL PARTICULARLY IF THEIR BONES ARE STILL LEAST YEARS OF GROWTH REMAINING THE PURPOSE OF BRACING IS TO HALT PROGRESSION OF THE CURVE IT MAY PROVIDE A TEMPORARY CORRECTION, BUT USUALLY THE CURVE WILL ASSUME ITS ORIGINAL MAGNITUDE WHEN BRACING IS ELIMINATED TREATMENTS • SURGERY: For those persons who already have a significant curve with a significant deformity surgery can reduce the curve and significantly reduce the deformity Usually surgery is reserved for teen and pre-teens who already have a curve around 40 degrees or more TREATMENTS SYNTHES IMPLANTS MEDTRONIC SOFAMOR DANEK IMPLANTS DEPUY SPINE IMPLANTS 1.INCREASE BACK STRENGTH: with back extension exercises 2.INCREASE FLEXIBILITY: stand tall and bend to touch toes while trying to keep knees locked 3.INCREASE ENDURANCE LEVELS: cardiovascular workouts, such as walking, bicycling or aerobic classes, to help with endurance levels 4.The Schroth Method: a series of exercises and therapy that teaches to exist and function in an unbalanced state Rather than actually straightening the spine, this method allows your brain to rethink its way of positioning your body and helps maintain balance This allows you to sit and stand straight, even though internally your spine is bent COMPLICATIONS OF SCOLIOSIS THE ASYMMETRICAL STRESSES ON JOINTS AND THE UNBALANCED FORCES ACTING •ONPAIN: MUSCLES RESULT IN BACK PAIN FOR MANY PEOPLE SPINAL DEGENERATION: LONG-STANDING ASYMMETRICAL LOADING OF THE SPINE •AFFLICTED BY SCOLIOSIS CAN PRODUCE DEGENERATIVE CHANGES IN THE DISCS, THE SPINAL JOINTS AND IN THE BONES THEMSELVES NEUROLOGICAL COMPROMISE: AS A RESULT OF A SEVERE SPINAL CURVATURE, •SECONDARY DEGENERATIVE CHANGES OR A COMBINATION OF FACTORS, SPINAL NERVES MAY BECOME TETHERED OR COMPRESSED NUMBNESS, WEAKNESS OR MUSCLE ATROPHY IN A LIMB IS POSSIBLE CARDIO RESPIRATORY COMPROMISE: IN SOME CASES, A SPINAL CURVATURE CAN •BECOME SO LARGE THAT THE HEART AND LUNGS MAY BECOME CROWDED THE CHEST CAVITY MAY NOT BE ABLE TO EXPAND AND CONTRACT NORMALLY WHICH ALSO HINDERS RESPIRATORY FUNCTION .. .WHAT IS SCOLIOSIS ? ? ?Scoliosis is an abnormal curve of the spine •Your spine is your backbone •It runs down your back with slight natural curves •But people with scoliosis have a spine... THE MOST COMMON TYPE OF SCOLIOSIS, IDIOPATHIC SCOLIOSIS, HAS NO SPECIFIC IDENTIFIABLE CAUSE THERE IS EVIDENCE THAT IDIOPATHIC SCOLIOSIS IS INHERITED •IDIOPATHIC SCOLIOSIS IS GROUPED BY AGE •IN... AGE AND YOUNGER, IT IS CALLED INFANTILE SCOLIOSIS •IN KIDS AGE - 10, IT IS CALLED JUVENILE SCOLIOSIS •IN OLDER KIDS AGE 11 - 18, IT IS CALLED ADOLESCENT SCOLIOSIS ? ?SCOLIOSIS MOST OFTEN AFFECTS