A Family Doctor's Tale - SCOLIOSIS

DOC I HAVE A CROOKED SPINE

Unlike Ankylosing scoliosis, scoliosis or crooked spine is more common in females. In the past most scoliotic cases are not detected until they are too late and the patients presents with deformed crooked spine in their adult hood.
Now with frequent school  visits by nurses and doctors, more early cases of scoliosis are detected and treated. 
One severe case of scoliosis occur in one teenager boy in the 1980 who had physiotherapy but did not improve and eventually had surgery with a metal rod placed in his spine to straighten the back.

Scoliosis  means a crooked spine.
 3% of the population have some form of scoliosis.
 For many people it's not much of a problem.
 For a small number of people, the curve gets worse as they grow.



1.The most common type of scoliosis is called idiopathic(or unknown cause.) scoliosis.

 2.Scoliosis can run in families, that is , it may be hereditary.


 Scoliosis usually begins at the age of 9-18 years when the bone starts growing during puberty. 

After this age, the curve usually become permanent as the bone stopped growing.

Scoliosis is more common in girls than boys.


Scoliosis may be easily noticeable. 

A curved spine can cause someone's body to tilt to the left or right. 

Many children with scoliosis have one shoulder blade that's higher than the other or an uneven waist with a tendency to lean to one side.


During a doctor visit in school, cases of scoliosis are easily detected during examination.

It's an easy test called the forward-bending test.
 It involves bending over, with straight knees, and reaching your fingertips toward your feet or the floor. Then the doctor will look at your back to see if your spine curves.
Someone with scoliosis may have a back that curves like an "S" or a "C."
This type of curve may be noticeable to others and can be uncomfortable.


If  you have confirmed scoliosis, then the doctor will decide whether treatment is necessary. 
He may order X-rays of your spine.

If the curve isn't mild, you may not need much treatment except for exercises to straighten your back and consistent monitoring of your spine.

If the curve is severe , an orthopedic surgeon will check on how severe your spine's curve is. 
He will looks at your  X-rays and measures the spine's curve in degrees.


Someone who has a mild curve may just need regular checkups to make sure the curve isn't getting worse.

 Someone with a more severe curve may need to wear a brace or have an operation.


1.Exercises for back and monitoring:

For mild cases, you may need to do some exercises to help straighten the back such as doing chin ups.


2.Treating With Braces

The  brace for scoliosis is meant to hold the spine in place so the curve doesn't get any worse. 

Some braces are made to be worn only at night.
Others are designed to be worn for much of the day. 


Most children need to wear their braces at least 20 hours a day, so that means wearing them to school. 

As he or she gets older and the spine curvature improve, braces are worn for a shorter period daily.


Braces now are lighter, more comfortable, and easier to wear.
There are many different types of braces.
Where the scoliosis is in the lower part of the back, the child often wear a brace called a thoracolumbosacral orthosis or TLSO for short.

This kind of brace comes up under the arms and is more comfortable than the bigger braces.
The two most popular TLSOs are the Boston brace and the Wilmington brace.


3.Surgery

Braces often are able to control the curvature.
Some children who have scoliosis eventually need an operation because of the increasing severity of the scoliosis. 

During the operation, the orthopedic surgeon fuses the bones in the spine together to correct the curve using metal rods, hooks, screws, and wires to hold everything in line until the bones heal.


The operation takes several hours, depending on how big the curve is and how many bones need to be fused.
After the operation,the child can usually go back to school about a month later.

He or she need not wear a brace and can return to some activities in 3 or 4 months, and most normal activities after a year.
Each patient's surgery and recovery might be different, depending on the type of surgery and the patient's age.


With improved treatment, more children with scoliosis can live normal lives.