SCOLIOSIS

SCOLIOSIS
Lateral curvature of the spine Most common during the growth spurt, early adolescent stage In most cases,80-85%, the cause is unknown-a condition called idiopathic scoliosis. In other cases scoliosis may develop as a result of degeneration of the spinal disk as seen with osteoporosis, or as hereditary condition that tends to run in the

family
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SCOLIOSIS
2 Types of curve in the spine Kyphosis- the spine curves inward Lordosis- the spine curves outward

CLASSIFICATION BASE ON THE AGE THE DEFECT DEVELOP

Infantile Idiopathic scoliosisstarts to appear in children less than 3 years old Juvenile idiopathic scoliosis- start to develop between 3 to 10 years of age Adolescent idiopathic scoliosisstart to develop in people that are over 10 years old Adult idiopathic scoliosis- start to develop in people who have reached skeletal maturity.

TYPES OF SCOLIOSIS
Congenital Scoliosis-"present at birth -is the result of malformation of part of the spine happens sometime

in the third to six week of

pregnancy, when the spine start to develop. -this group is associated with abnormalities of the vertebrae such

as hemi- or fused vertebrae.

TYPES OF SCOLIOSIS
Neuromuscular Scoliosis- in this type of scoliosis , a problem occurs during the

formation of the bones of the

spine. -it develops in people with birth defects, muscular dystrophy, and palsy among others.

TYPES OF SCOLIOSIS
Degenerative scoliosisoccurs in older adults. It is 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.

TYPES OF SCOLIOSIS
Functional scoliosis-in this condition the spine is normal but an abnormal curve develops, which

may be caused by one leg being

shorter than the other or by muscle spasm in the back. - This type of scoliosis is often relieve when the underlying condition is treated

SYMPTOMS
Abnormal curve of the spine Shoulder or hips appearing uneven Backache or low back pain Fatigue Shortness of breath and chest pain

ASSESSMENT: SCOLIOSIS
visible curve fails to straighten when the child bends forward and hangs arms down toward feet (Adams position) Asymmetrical shoulder height, scapula and flank shape rib prominence and rib humps Screening begins at 8 yrs.

DIAGNOSTIC PROCEDURES
X-rays Radionuclide Bone Scan Magnetic Resonance Imaging (MRI) Computer Tomography Scan (CT Scan) Blood Test Ultrasound (also called sonography)

TREATMENT SCOLIOSIS
Specific treatment of scoliosis will determined by the physician based on: Patients age, overall health and medical history

The extent of the condition

Patients tolerance to specific medication , procedures, or therapies Expectation for the course of the condition Patients opinion or preference

MANAGEMENT: SCOLIOSIS
Milwaukee Brace- worn between 16-23 hrs./day
Not curative, but preventive: Slows/Halts progression of the curvature when child reaches skeletal maturity Inspect the skin for signs of redness or breakdown Keep the skin clean and dry, avoid lotions and powders Advise the child to wear soft, nonirritating clothing under the brace

MANAGEMENT: SCOLIOSIS
Supplemental exercises: to prevent atrophy of spinal and abdominal muscles Support in coping: Adolescents may modify lifestyle, may feel stigmatized from peers by being different

MANAGEMENT: SCOLIOSIS

MANAGEMENT: SCOLIOSIS
Surgery: Thoracic Scoliosis, metal rods can be inserted along the spine (called Cotrel-Dubousset Instrumentation). These rods acts as braces to straighten the spin and prevent further deterioration of the scoliosis. These rods are usually left in the spine throughout life. This type of surgery does not require patient to wear plaster jacket after operation. The stay in the hospital is about 7 to 9 days and may return to school in about 1 month. Life after surgery returns to normal by about 9 month, except that the body contact sports are not permitted.

MANAGEMENT: SCOLIOSIS
Surgery: Lumbar scoliosis is treated with other operation including fusion, and the underarm brace is required for up to 6

months after surgery.

-if fusion is contemplated, pre-operative traction or plaster correction using plaster jacket wedged open on the concave side (Risser), may be used to gain as much as soft tissue stretching as possible.

COMPLICATION
Emotional Problem Low Self-Esteem Cardio-Respiratory Dysfunction Motor Sensory Deficit Infections after multi-Surgery Short Life Expectancy if untreated