Scoliosis

The Pennsylvania Department of Health has adopted regulations requiring each child in grades 6 and 7 to be screened for scoliosis.

What Is Scoliosis?

  • Scoliosis is a lateral and rotary curve of the spine.
  • Normally the spine is straight when viewed from the back.  In scoliosis, the spine twists to the side.

What Are the Causes?

  • Idiopathic - A curve that has no known cause.  70% of all scoliosis detected is idiopathic.
  • Congenital- A birth defect of the spine, which occurs during the development of the body
  • Neuromuscular- A curve, which results from a muscular imbalance in the back.
  • Injury to the spine.

How Is Scoliosis Usually Detected?
A family member may notice a high shoulder or hip, a protrusion on one side of eh back or chest, difficulty in fitting slacks, or and uneven hem.  These findings could indicate bad posture, but they may also suggest scoliosis.

  • During a physical exam by a physician.
  • The "Forward Bending Test" is a simple way to detect scoliosis.  It can be done in less than a minute, and may be performed by a child's family member or a health professional.
  • Scoliosis should be detected before the curve progresses far enough to be noticed in the above ways.  Many times, if detected before the child reaches full bone growth, the curve can be reduced or kept from increasing without surgery.  Annual screening programs held in many school districts, are one of the best ways of early scoliosis detection.

The Simple Forward Bending Test

When a child is in standing position:

  • Are the shoulders level?
  • Are the hips level?
  • Is one shoulder blade more prominent?
  • Are there unequal distances between the arms and body?
  • Does the spine appear curved?

Have your child bend forward:

  • Is there a prominent hump on one side of the back when the child is bending forward?

Who Is Most Likely to Have Idiopathic Scoliosis?

  • Severe scoliosis occurs in girls more frequently than boys.
  • Scoliosis is usually detected in the early ages of 6th graders.  Many children by that age are not taken for regular physical exams.
  • Scoliosis is not rare.  Many people are never aware that they have scoliosis.  It is difficult to determine which case will progress.  It is recommended that every person suspected of have a curve be examined by a physician.

Can Scoliosis Be Cured?

  • It can be effectively controlled and even corrected to some extent.  Correction depends on the age of the child, cause and the severity of the curve, and how soon treatment is begun.  Mild scoliosis may progress until the child stops growing.  Moderate and Severe scoliosis may continue to progress even after the skeleton has stopped growing and may require follow up examinations throughout life.  Early indication and treatment will produce the best results in the end.

Is Scoliosis Hereditary?
There is a tendency for idiopathic scoliosis to occur in families.  If one case is diagnosed, all other members of the family should be checked.

What Are The Problems of Untreated Scoliosis?

  • Pressure on vital organs, commonly heart and lungs, decreasing their capacity later.
  • Back and joint pain later in life.
  • Decreased flexibility to perform skilled tasks.
  • Changes in appearance that can lead to emotional and psychological problems.

What Happens When One Is Referred For Follow-Up as Possibly Having Scoliosis?

  • The Bending Test shows only the possibility of a curve.  A physician must then examine the back.  Standing position X-rays may be used to make definite diagnosis.
  • There are generally 3 approaches to treatment:
  1. A mild curve should be watched and X-rayed regularly to make sure it is not increasing.  X-ray exams of the spine is the only objective measurement of curve progression.
  2. A mild curve, which has been shown to be progressing, and moderate curves can be treated with spinal braces to stop progression when growth is completed.
  3. A severe curve, or one not readily controlled by more conservative means, could be recommended for surgical correction.

EARLY DETECTION AND TREATMENT IS THE KEY TO POSSIBLE PREVENTION OF SERIOUS SPINAL DEFORMITIES.

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