SCOLIOSIS
What is scoliosis?
Scoliosis is a medical condition characterized by an abnormal curvature of the spine. The spine typically has a natural S-shaped curve, but in scoliosis, the spine may have an abnormal sideways curvature, resembling a C or S shape.Scoliosis is more common in females than males. This condition can occur in any part of the spine, including the neck (cervical), upper back (thoracic), or lower back (lumbar).
The ICD-10 code for scoliosis is M41.9.
Mechanism of Injury
The two types (both may be aggravated by overuse, trauma, or loading imbalance) are:
A. Nonstructural or flexible due to leg length discrepancy or vertebral osteoid
osteoma.
B. Structural or non flexible, which tends to be more severe and not correctable by side bending.
1. Idiopathic (85 %)
2. Congenital (10%)
3. Neuromuscular (5%)
Scoliosis symptoms
Many times the condition is asymptomatic but can present with a dull ache of the back.
A. Shoulder-level asymmetry as seen from behind with patient standing.
B. Asymmetry of the hemithoraces as seen by inspection of the spine from the rear with forward flexion (Adam’s test).
C. The scoliotic curve can be seen when using the level of the
iliac crest and the ears as reference points.
Signs of scoliosis
Signs of scoliosis may include-
1. Uneven shoulders or hips
2. One shoulder blade that appears more prominent than the other
3. Uneven waistline or hips
4. Leaning to one side
5. Back pain or discomfort
6. Visible curvature of the spine
Differential Diagnosis
Spondylolysis,secondary scoliosis (spinal cord tumor, syringomyelia, Friedreich’s ataxia, leg length discrepancy)
Scoliosis Treatment
Treatment depends on the degree of curvature.
A. Mild scoliosis (<20°): No treatment is required as long as the curve is nonprogressive.
B. Moderate (20 to 45°): Bracing (e.g.,Milwaukee or Boston) should be worn.A comprehensive program to strengthen the abdominal musculature as well as
maintain an ideal body weight is prescribed. Adolescents with scoliosis should be allowed
relatively unrestricted physical activity,including competitive athletics.
C. Severe (>45°): Possible surgical fusion with instrumentation.
Scoliosis surgery
Scoliosis surgery is a treatment option for severe cases of scoliosis where the curvature of the spine is significant and causing pain, discomfort, or affecting the individual's quality of life. The surgical procedure aims to correct and stabilize the curvature using various techniques, such as spinal fusion or instrumentation.
Exercise for scoliosis
Exercise can be beneficial for individuals with scoliosis, but it should be done under the guidance of a healthcare professional. Some exercises that may help improve scoliosis include:
1. Stretching exercises: These can help improve flexibility and relieve muscle tension in the back.
2. Strengthening exercises: Targeting the muscles in the back, abdomen, and hips can help provide support to the spine.
3. Core exercises: Strengthening the core muscles can help improve posture and stability.
4. Yoga or Pilates: These practices focus on improving flexibility, strength, and posture.
5. Swimming: It is a low-impact exercise that can help strengthen the muscles without putting excessive strain on the spine.
It is important to consult with a healthcare professional or a physical therapist who specializes in scoliosis to develop an exercise plan to an individual's specific needs and condition.
Complications
Progression of curve, respiratory compromise with early deaths from respiratory failure with curves greater than 60° if left untreated; lumbar curves greater than 50° have high risk for degenerative disc disease and pain.
Prevention
Early diagnosis and regular follow-up
Lumbar scoliosis
Lumbar scoliosis specifically refers to scoliosis that affects the lower back or lumbar region of the spine. It involves an abnormal sideways curvature in the lumbar vertebrae.
Famous people with scoliosis
There are many famous people who have had scoliosis, including notable figures such as Princess Eugenie of York, actress Elizabeth Taylor, Olympic gymnast Usain Bolt, and actress Shailene Woodley.