Scoliosis
Essay Preview: Scoliosis
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Scoliosis, what is it? Not many people know exactly what it is. This disease has been around for a long time. Scoliosis is something this student thinks more people should know about and get checked frequently for too. This writer is diagnosed with scoliosis and doing this paper has helped her learn more about her own condition. The main focus of this paper is to help inform and educate people in society about scoliosis.
Because of a tough schedule, this author had to rely on the Internet for all of her research. There is a months worth of research put into this paper. All together nine hours were spent at home researching on the Internet. Ten lunch hours were spent on the Internet at work. This student conducted eleven surveys over the Internet.
Everyone’s spine has natural curves, but there are people who have spines that curve from side to side. This side-to-side curve is known as scoliosis. The meaning of scoliosis is a lateral curvature of the spine. Scoliosis affects the entire skeletal system including the spine, ribs, and pelvis. It impacts upon the brain and central nervous system and affects the body’s hormonal and digestive systems. It can deplete the body’s nutritional resources and damage its major organs including the heart and lungs. Cerebral palsy, muscular dystrophy, birth defects, and Marfan syndrome are just some things that can cause scoliosis. Scoliosis usually develops in the thoracic spine (upper back) or the thoracolumbar
area of the spine, which is between the thoracic spine and lumbar spine (lower back). It may also occur just in the lower back. The curvature of the spine from scoliosis may develop as a single curve (shaped like the letter C) or as two curves (shaped like the letter S). About four percent of the population has scoliosis.
There are four main types of scoliosis. There is congenital scoliosis, juvenile scoliosis, idiopathic scoliosis, and degenerative scoliosis. Congenital scoliosis is a relatively rare form of congenital malformation of the spine. These patients will often develop scoliotic deformities in their infancy. Juvenile scoliosis is another uncommon form is the development of scoliosis in childhood. Idiopathic scoliosis (also referred to as adolescent scoliosis) is by far the most common form of scoliosis, which develops in adolescents and progresses mostly during the adolescent growth spurt. Degenerative scoliosis can also develop later in life, as joints in the spine degenerate and create a bend in the back. This condition is sometimes called adult scoliosis.
Scoliosis is discovered by the Adam test, also known as the forward bend test. What the child does during this test is take off their shirt, stands up straight with their feet together. The examiner will check the shoulders, shoulder blades, and hips. Then they must bend forward. In a child with scoliosis, bending forward will reveal an asymmetry of the back or posterior chest wall causing an elevation of one side of the back, or a rib hump. The next step is to have x-rays
taken. These x-rays will determine the degree of the curve. It is very important that you keep getting x-rays done to determine if the curve is getting better. The degree helps to figure out what treatment should be used.
Children with progressive curves or curves that are above 30 degrees will need to have treatment. The main treatments are bracing and surgical correction, although surgery is usually reserved for children with curves over 45 to 50 degrees, or which don’t respond to bracing. There are five different types of bracing. The types of braces are the Thoracolumbo sacral orthosis, the Charleston bending brace, the Milwaukee brace, the Boston Brace, and the Copes Brace. The Thoracolumbo sacral orthosis brace is custom molded, fits beneath clothing, and is worn for most of the day and night. The Charleston bending brace is usually used for single lumbar curves and is worn at night. The Milwaukee brace extends up to the neck and isn’t used very much anymore. The Copes brace is custom-cast, custom-fitted, and custom-fabricated to the exact body dimensions of each patient. It is designed to fit skin tight to the patient.
Bracing doesn’t always help. The other option is to have surgery. Posterior spinal fusion is the most common surgical procedure that is used. Rods are permanently placed in your back, they don’t cause any problems. There are some things that you should consider before surgery. First remember complication of surgery can include: hooks becoming dislodged, fracture of the
rods, skin protrustion of the upper end of the rods, pseudarthrosis (spine did not fuse), and pain where there once was none (neurological problem). Younger patients are susceptible to crankshaft phenomenon (worsening of the rotation and rib deformity). Scoliosis affects the entire skeleton (i.e. rib deformities) and impacts on neurological and hormonal systems. Surgical rods do nothing to address the wide range of bodily structures and systems affected by the disease. Initial average loss of spinal correction post-surgery is 3.2 degrees in the first year and 6.5 after two years with continued loss of 1.0 degrees per year throughout life.
Congenital scoliosis is associated with congenital heart disease, genitourinary abnormalities, and defects of the spinal column. Children and adults with congenital scoliosis should be closely followed. Congenital scoliosis is usually only discovered on a MRI, but sometimes they can be seen on an x-ray. Bracing is the only non-operative treatment. Bracing has a limited value when it comes to congenital scoliosis. Exercises, biofeedback, chiropractic, acupuncture, and electrical stimulations are other types of non-operative treatment, but they don’t work. Brace treatment is designed only to delay surgery until a more optimal age, usually the onset of the pubertal growth spurt. Braces for congenital scoliosis are not intended to prevent surgery as they are in idiopathic scoliosis.
Majority of the type patients with congenital scoliosis will need to have surgery done. Surgeons must stop the imbalance growth with a spine fusion. There are
four major operations for congenital scoliosis: posterior spine fusion, combined anterior and posterior fusion, growth-arrest surgery (epiphysiodesis), and hemivertebrae excision. Each have their place and it is the responsibility of the surgeon to select that operation which is best for the individual child based on the curve pattern, the anomalies present, the rate of progression and the age. In congenital