|
||||||
|
Early detection important in scoliosis diagnosis John Anderson, M.D., and Daniel Hoernschemeyer, M.D., pediatric orthopaedic surgeons at University Hospital, are working with elementary and middle-school nurses throughout Missouri to help screen children for spinal curvatures. Scoliosis is the most common deformity of the spine and is diagnosed when lateral and rotational abnormalities are present. Lateral curvatures are indicated by a side-to-side bow, or S-shaped spinal column, while rotational deformities occur when the vertebrae are twisted to one side or the other. Both aspects of scoliosis must be present to make a diagnosis of the condition. Scoliosis can affect infants, adolescents or adults, but it is best diagnosed as early as possible. To assist in the detection of scoliosis, Anderson and Hoernschemeyer have given presentations and created educational materials for nurses to use as a tool in screening elementary and middle-school students. “We have a complete program for screening our students for scoliosis,” said Susan Robinson, coordinator of health services for the Columbia Public School system. “We have found the screening information from Dr. Anderson to be useful in our examination process, which also helps us in our efforts as school nurses to assist families in accessing follow-up care when needed.” The educational material includes a poster with tips on recognizing scoliosis by looking for physical signs that the condition is present, such as:
The primary age of onset for scoliosis is between 10 and 15, occurring equally in both genders. However, females are eight times more likely to progress to a curve magnitude that requires treatment. Most cases of scoliosis are mild and require no treatment. However, to make sure that the curve does not get worse, an individual diagnosed with the condition should be examined regularly by a physician. If the curve is more than 50 degrees side-to-side, there is a high probability that the curvature will increase one additional degree each year throughout adulthood. “Curvatures resulting from idiopathic, or unknown causes, hardly ever get to the point that they are debilitating,” said Anderson. “But they can be cosmetically displeasing and will need intervention in the way of a brace if the spine curves more than 25 degrees. If the disease results in a lateral abnormality of more than 50 degrees, I would recommend a surgical approach to prevent progression of the condition.” The typical surgical method used to halt the progression of scoliosis is known as posterior spinal fusion and instrumentation. The procedure involves the placement of screws, hooks or wires into the outer edges of the vertebrae in the area of the spinal abnormality. The screws, hooks or wires connect to rods placed on each side of the spine. Corrective forces are applied to the implants to straighten the spine. “We always explain to the family that the goal of the surgery is to prevent progression of the curvature,” said Anderson. “But a majority of the time we get a substantial correction of the deformity. Patients usually return back to normal activity within six months of surgery. “Kids bounce back so fast,” said Anderson. “Most cases of scoliosis don’t get worse, and periodic checkups may be all that is needed. Children with a more severe curve, however, may require a brace or surgery.” In addition to the educational material Anderson provides to educators, he also conducts a weekly scoliosis clinic each Friday afternoon at University Hospital in Columbia. For more information on scoliosis or to make an appointment to see a pediatric orthopaedic specialist at University Hospital, please call (573) 884-2522. |
|||||
|
||||||
“A normal spine has three front-to-back curves between the neck and the pelvis,” said Anderson. “A child with scoliosis will present with a spine that also curves abnormally to the side and is twisted either to the right or the left.”
“You want to catch it somewhat early so that you can implement treatment to keep the condition from progressing,” said Anderson. “Early diagnosis before adolescent growth spurts is important, because that’s when the curvatures become more progressive.”
