WHAT IS SCOLIOSIS ? FULL

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 4 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 3 AND YOUNGER, IT IS CALLED INFANTILE SCOLIOSIS.
•IN KIDS AGE 4 - 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

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•
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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

1.X RAY: Currently, x-rays are the most cost-effective method
for diagnosing scoliosis. X rays appear to be fairly accurate
for detecting scoliosis in the upper back (the thoracic
region), but not scoliosis in the lower back (the lumbar
region).

•.Children

and young adolescents need x-rays every few
months to detect increasing severity.


TESTS TO DETECT SCOLIOSIS
2.

Magnetic Resonance Imaging. Magnetic resonance imaging (MRI) is an
advanced imaging procedure that does not use radiation, as x-rays do. 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

3. 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 2 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.