Scoliosis affects roughly about seven million individuals in the United States. It is distributed more in adolescent females (adolescent idiopathic scoliosis) compared to any other demographic group. The condition is characterized by an abnormal curvature in the spinal column. Instead of a normal straight outline usually seen on an X-ray, there is a C or S-shaped outline. The majority of cases have no specific cause (up to 80 %) but, genetics seems to contribute by some degree. Other causes include congenital and neuromuscular causes among others.
A comprehensive physical examination together with an appropriate radiographic scan will in most cases confirm the diagnosis. The major areas of concern during the physical exam include abnormalities involving the curvature of the spine, a possible shift in the position of the trunk and abnormalities in the neuromuscular system. Radiographs may need to be done serially to monitor the progress. Future prospects in diagnosis methods include use of genetic markers.
It is not possible to have a perfectly normal spine even with the most advanced modes of therapy. The treatments options available for consideration aim to improve function by reducing the curvature and reducing symptoms.
The choice of the mode of treatment depends on the severity of the curvature. Small curvatures of less than 45 degrees in persons still growing are usually just observed for some time for progress. If the progress is too rapid as to lead to severe symptoms, then intervention is necessary. Adults with small curvatures which have mild symptoms may also be observed in the same manner. Specialized wheel chairs have been designed to help individuals whose daily activities involve long sitting hours.
Braces are devices designed to provide stability and they assist patients to attain a more upright posture. They are designed to cover the torso but may at times extend to the neck. They are however, only useful for curvatures less than 45 degrees. Curvatures more than 45 degrees are considered for surgery which is done by a spinal deformity surgeon. Surgical methods available include access of the spine through an incision in the chest wall or through the back followed by bone grafting of the vertebrae.
In order to achieve better results it is important to utilize as much of physiotherapy and occupational therapy as possible. Patients with scoliosis are equipped with techniques on how to perform their daily activities without being too dependent on other people.
With proper treatment, patients will have life spans comparable to the unaffected population. It should be emphasized that family support is key in achieving this.
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