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SCOLIOSIS
Scoliosis Facts
| Fact | Description |
|---|---|
| Definition | a lateral "S" or "C" shaped curvature of the spine, rotational deformity of the spine and ribs, classified as either STRUCTURAL or COMPENSATORY |
| etiology | congenital , acquired or idiopathic |
| clinical s/s | most often in girls, begin with groth spurt bt ages 10 and 13 yrs, not associated with pain or discomfort |
| 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 |
| 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 |
| dx | observation by parent, routine screening and confirmed by radiology |
| 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 |
| bending forward assesment | symmetry of thorax |
| d-test | MRI, CAT scan, bone scan, moir photography, scoliometry, plumb bob |
| 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 |
| 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 |
| 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 |
| severe cases | curvatures greater than 40 degrees, surgical correction |
| ns dx | risk for noncompliance, act intolerance, imp physical mobility, risk fro impaired skin integrity, knowledge deficit |