Scoliosis

Scoliosis:  a lateral curvature of the vertebral column., scoliosis may occur in the thoracic, lumbar, or thoracolumbar spinal segment.  The curve may be convex to the right ( more common in lumbar curves ) or to the left ( more common lumbar curves)  Rotation of the vertebral column around its axis occurs and may cause rib cage deformity. There are two different types of scoliosis; functional  (postural ) ,and   structural .  They are both associated with kyphosis ( humpback ) and lordosis
( swayback ). Scoliosis usually affects adolescent girls. Most school now check adolescents for scoliosis, check with your school district if your interested.

Functional Scoliosis:  it is a results from  poor posture or a discrepancy in leg lengths. 
Structural Scoliosis:  it involves deformity of the vertebral bodies.  It may be congenital ( present at and existing from the time of birth ) such as wedge vertebrae, fused ribs or vertebrae, or hemivertebrae.  Paralytic ( affected with paralysis ) such as polio, cerebral palsy, or muscular dystrophy, or idiopathic ( occurring without known cause ), the most common form, may be transmitted as an autosomal dominant ( a non  - sex- determining chromosome ) or multifactorial trait, it appears in a previously straight spine during the growing years.

Symptoms:

Curving of the spine ( usually in the thoracic segment ), with convexity to the right  (having a rounded, somewhat elevated surface ), and compensatory curves ( S curves ) in the cervical segment above and the lumbar segment below, both with convexity to the left.
Backache
Fatigue
Dyspnea ( difficulty breathing )
Unequal shoulder heights, elbow levels, and heights of the iliac crests.

Your doctor may want to take an X-ray of your spine

Treatment:

The most effective treatment should begin very early, when spinal deformity is still subtle.
Your doctor will  determine what course of therapy and or treatment depending on the severity of the deformity.
A brace may have to worn (Milwaukee brace )
Surgery may be needed
Close observation and exercise

A mild curve ( less than 25 degrees ) can be monitored by X -Rays and an examination by your doctor every 3 months. Along with exercise program to strengthen the turso muscles and help prevent curve progression.  A heel lift may help.

A curve of 25 degrees to 40 degrees requires spinal exercises and a brace.  Your doctor may prescribe you to undergo transcutaneous electrical nerve stimulation ( TENS ).  A brace helps to halt progression in most patients but does not reverse established curvature.

A curve of 40 degrees or more requires surgery ( spinal fusion ), since a lateral curve progresses at the rate of 1 degree a year even after skeletal maturity. 

 * Early detection is the Key.  See your doctor if you suspect and or have any of the symptoms above.

 * If the patient have a brace, keep in mind:  Do not insert anything or let anything get under the cast and to immediately report cracks in the cast, and if there is pain, swelling, skin breakdown, and  numbness see your doctor Promptly.

Cast Syndrome:  a serious complication, this syndrome may follow spinal surgery and application of a body cast. 
The patient may experience nausea, abdominal pressure, and vague abdominal pain. Experts believe  the reason for cast syndrome is probably due to hypertension of the spine. Hypertension of the spine accentuates lumbar lordosis, with compression of the third portion of the duodenum between the superior mesenteric artery anteriorly, and the aorta and vertebral column posteriorly.  High intestinal obstruction produces nausea, vomiting, and ischemic infraction of the mesentery.
Untreated cast syndrome may be fatal. * Call your doctor immediately, this syndrome may develop as late as several weeks or months after application of the cast.

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