Scoliosis Facts
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| Definition | a lateral "S" or "C" shaped curvature of the spine, rotational deformity of the spine and ribs, classified as either STRUCTURAL or COMPENSATORY
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| etiology | congenital , acquired or idiopathic
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| clinical s/s | most often in girls, begin with groth spurt bt ages 10 and 13 yrs, not associated with pain or discomfort
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| patho | spine begin s to curve laterally, causes vertebral rotation, ribs in the concave side of the curve are forced together, covex side are spread apart
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| this causes | a norrowed rib cage laterally and the development of the rib hump to compensate, the lateral rotation of the vertebra effects the position and spacing of vertebral disc
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| dx | observation by parent, routine screening and confirmed by radiology
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| standing assesment | symmetry of shoulder , scapulae, rib cage and hips, symmetry of soft tissue curvature at flanks and waist, straightness of the spine, and prominence and alignment of spinal processes
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| bending forward assesment | symmetry of thorax
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| d-test | MRI, CAT scan, bone scan, moir photography, scoliometry, plumb bob
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| medical management | goal is to stop or limit the progression of the curve, max chances of optimal alignment, prevent complication, decrease the potential need for surgical correction
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| mild cases | 10=20 degrees, (up to 10 degrees = norm), exercise to improve posture and muscle tone, maintain flexibility, monitored q 3 months, x-ray done q 6 months , followed until completion of spinal growth
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| moderate cases | curves from 20-40 degrees, bracing to prevent curve from progressing , worn 23 hrs per day, worn until spinal growth complete, electrical stimulation
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| severe cases | curvatures greater than 40 degrees, surgical correction
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| ns dx | risk for noncompliance, act intolerance, imp physical mobility, risk fro impaired skin integrity, knowledge deficit
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