|
June is Scoliosis Awareness Month
Scoliosis
is a sideways curvature of the spine that occurs most often during the growth
spurt just before puberty. While scoliosis can be caused by conditions such as
cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown.
About 3% of adolescents have scoliosis.
Most
cases of scoliosis are mild, but some spine deformities continue to get more
severe as children grow. Severe scoliosis can be disabling. An especially
severe spinal curve can reduce the amount of space within the chest, making it
difficult for the lungs to function properly.
Children who
have mild scoliosis are monitored closely, usually with X-rays, to see if the
curve is getting worse. In many cases, no treatment is necessary. Some children
will need to wear a brace to stop the curve from worsening. Others may need
surgery to keep the scoliosis from worsening and to straighten severe cases of
scoliosis.
Signs and symptoms of
scoliosis may include:
·
Uneven shoulders
·
One shoulder blade that
appears more prominent than the other
·
Uneven waist
·
One hip higher than
the other
If
a scoliosis curve gets worse, the spine will also rotate or twist, in addition
to curving side to side. This causes the ribs on one side of the body to stick
out farther than on the other side.
Go
to your doctor if you notice signs or symptoms of scoliosis in your child. Mild
curves, however, can develop without the parent or child knowing it because
they appear gradually and usually don't cause pain. Occasionally, teachers,
friends and sports teammates are the first to notice a child's scoliosis.
Doctors
don't know what causes the most common type of scoliosis — although it appears
to involve hereditary factors, because the disorder tends to run in families.
Less common types of scoliosis may be caused by:
·
Neuromuscular
conditions, such as cerebral palsy or muscular dystrophy
·
Birth defects
affecting the development of the bones of the spine
·
Injuries to or
infections of the spine
Risk factors for
developing the most common type of scoliosis include:
·
Age. Signs and symptoms typically begin
during the growth spurt that occurs just prior to puberty.
·
Sex. Although both boys and girls develop
mild scoliosis at about the same rate, girls have a much higher risk of the
curve worsening and requiring treatment.
·
Family
history. Scoliosis can
run in families, but most children with scoliosis don't have a family history
of the disease.
While most people with
scoliosis have a mild form of the disorder, scoliosis may sometimes cause
complications, including:
·
Lung
and heart damage. In severe
scoliosis, the rib cage may press against the lungs and heart, making it more
difficult to breathe and harder for the heart to pump.
·
Back
problems. Adults who had
scoliosis as children are more likely to have chronic back pain than are people
in the general population.
·
Appearance. As scoliosis worsens, it can cause more
noticeable changes — including uneven hips and shoulders, prominent ribs, and a
shift of the waist and trunk to the side. Individuals with scoliosis often
become self-conscious about their appearance.
The doctor will
initially take a detailed medical history and may ask questions about recent
growth. During the physical exam, your doctor may have your child stand and
then bend forward from the waist, with arms hanging loosely, to see if one side
of the rib cage is more prominent than the other.
Your doctor may also
perform a neurological exam to check for:
·
Muscle weakness
·
Numbness
·
Abnormal reflexes
Plain X-rays can confirm
the diagnosis of scoliosis and reveal the severity of the spinal curvature. If
a doctor suspects that an underlying condition — such as a tumor — is causing
the scoliosis, he or she may recommend additional imaging tests, such as an
MRI.
Most children with
scoliosis have mild curves and probably won't need treatment with a brace or
surgery. Children who have mild scoliosis may need regular checkups to see if
there have been changes in the curvature of their spines as they grow.
While there are guidelines
for mild, moderate and severe curves, the decision to begin treatment is always
made on an individual basis. Factors to be considered include:
·
Sex. Girls have a much higher risk of
progression than do boys.
·
Severity
of curve. Larger curves
are more likely to worsen with time.
·
Curve
pattern. Double curves,
also known as S-shaped curves, tend to worsen more often than do C-shaped
curves.
·
Location
of curve. Curves located
in the center (thoracic) section of the spine worsen more often than do curves
in the upper or lower sections of the spine.
·
Maturity. If a child's bones have stopped growing,
the risk of curve progression is low. That also means that braces have the most
effect in children whose bones are still growing.
If your
child's bones are still growing and he or she has moderate scoliosis, your
doctor may recommend a brace. Wearing a brace won't cure scoliosis or reverse
the curve, but it usually prevents further progression of the curve.
The most
common type of brace is made of plastic and is contoured to conform to the
body. This brace is almost invisible under the clothes, as it fits under the
arms and around the rib cage, lower back and hips.
Most braces
are worn day and night. A brace's effectiveness increases with the number of
hours a day it's worn. Children who wear braces can usually participate in most
activities and have few restrictions. If necessary, kids can take off the brace
to participate in sports or other physical activities.
Braces are
discontinued after the bones stop growing. This typically occurs:
·
About two years after girls begin to menstruate
·
When boys need to shave daily
·
When there are no further changes in height
Severe
scoliosis typically progresses with time, so your doctor might suggest
scoliosis surgery to reduce the severity of the spinal curve and to prevent it
from getting worse. The most common type of scoliosis surgery is called spinal
fusion.
In spinal
fusion, surgeons connect two or more of the bones in the spine (vertebrae)
together, so they can't move independently. Pieces of bone or a bone-like
material are placed between the vertebrae. Metal rods, hooks, screws or wires
typically hold that part of the spine straight and still while the old and new
bone material fuses together.
If the
scoliosis is progressing rapidly at a young age, surgeons can install a rod
that can adjust in length as the child grows. This growing rod is attached to
the top and bottom sections of the spinal curvature, and is usually lengthened
every six months.
Complications
of spinal surgery may include bleeding, infection, pain or nerve damage.
Rarely, the bone fails to heal and another surgery may be needed.
Coping with scoliosis
is difficult for a young person in an already complicated stage of life. Teens
are bombarded with physical changes and emotional and social challenges. With
the added diagnosis of scoliosis, anger, insecurity and fear may occur.
A strong, supportive
peer group can have a significant impact on a child's or teen's acceptance of
scoliosis, bracing or surgical treatment. Encourage your child to talk to his
or her friends and ask for their support.
Consider joining a
support group for parents and kids with scoliosis. Support group members can
provide advice, relay real-life experiences and help you connect with others
facing similar challenges.
Article
information taken from: www.mayoclinic.org
|
