Definition
Scoliosis is a curvature towards the side of the spine which is a deformity (disorder) rather than a disease
Clinical Symptoms
From a history of illness, first of all do not complain about any pain. New scoliosis usually recognized by parents as a child growing up, which is visible state of the shoulder is not the same height, protrusion of the scapula is not the same, or hip is not the same. In these circumstances, the degree of bending curve usually has more than 30 degrees.
On physical examination, can be done several checks, among others:
* Stand up straight, to see what they are:
o Asymmetry shoulders, neck, ribs, pelvis, scapula
o Plum line (collinear between the neck and hips)
o Body arm distance (the distance between the arm with the body)
* Bending, to see what they are:
o Rotation (rotation of the spine)
o The degree of curvature (kyphosis)
* Measuring the difference in leg length (leg length discrepancy)
* Looking for:
o Flexibility of joints
o sinuses on the skin
o Hairy patches
o palpable midline defects
Management
The purpose of the management of scoliosis include four important things:
1. Prevent progression and maintain a balance
2. Maintaining respiratory function
3. Reducing pain and improving neurological status
4. Cosmetics
The therapeutic options can be selected, known as "The three O's" are:
1. Observation
Monitoring carried out if the degree of scoliosis is not so heavy, that is <25o on the bone that is still growing or <50o at the bone has stopped growing. Average Saar bones stop growing at age 19.In this monitoring, carried out the control plain backbone at certain times. Photos of the first control performed 3 months after the first visit to the doctor. Then about 6-9 months for the degree of <20 and 4-6 months for a degree> 20.
2. Orthosis
Orthosis in this case is the use of braces that are known by the name of the brace.
Scoliosis is a curvature towards the side of the spine which is a deformity (disorder) rather than a disease
Clinical Symptoms
From a history of illness, first of all do not complain about any pain. New scoliosis usually recognized by parents as a child growing up, which is visible state of the shoulder is not the same height, protrusion of the scapula is not the same, or hip is not the same. In these circumstances, the degree of bending curve usually has more than 30 degrees.
On physical examination, can be done several checks, among others:
* Stand up straight, to see what they are:
o Asymmetry shoulders, neck, ribs, pelvis, scapula
o Plum line (collinear between the neck and hips)
o Body arm distance (the distance between the arm with the body)
* Bending, to see what they are:
o Rotation (rotation of the spine)
o The degree of curvature (kyphosis)
* Measuring the difference in leg length (leg length discrepancy)
* Looking for:
o Flexibility of joints
o sinuses on the skin
o Hairy patches
o palpable midline defects
Management
The purpose of the management of scoliosis include four important things:
1. Prevent progression and maintain a balance
2. Maintaining respiratory function
3. Reducing pain and improving neurological status
4. Cosmetics
The therapeutic options can be selected, known as "The three O's" are:
1. Observation
Monitoring carried out if the degree of scoliosis is not so heavy, that is <25o on the bone that is still growing or <50o at the bone has stopped growing. Average Saar bones stop growing at age 19.In this monitoring, carried out the control plain backbone at certain times. Photos of the first control performed 3 months after the first visit to the doctor. Then about 6-9 months for the degree of <20 and 4-6 months for a degree> 20.
2. Orthosis
Orthosis in this case is the use of braces that are known by the name of the brace.
Usually an indication of the use of this tool are:
* On the first visit, found the degree of bending of about 30-40o
* There is a progressive increase in degree as much as 25 degrees.
This type of orthosis tools include:
* Milwaukee
* Boston
* Charleston bending brace
This tool can provide significant results when used on a regular basis 23 hours a day to 2 years after menarche.
3. Operation
Not all of scoliosis surgery. Indication of the surgery in scoliosis are:
* There is a progressive increase in the degree of bending of> 40-45 degrees in a growing child
* There is a failure after the use of tools orthosis
* There is a degree of curvature> 50 degrees in adults
* On the first visit, found the degree of bending of about 30-40o
* There is a progressive increase in degree as much as 25 degrees.
This type of orthosis tools include:
* Milwaukee
* Boston
* Charleston bending brace
This tool can provide significant results when used on a regular basis 23 hours a day to 2 years after menarche.
3. Operation
Not all of scoliosis surgery. Indication of the surgery in scoliosis are:
* There is a progressive increase in the degree of bending of> 40-45 degrees in a growing child
* There is a failure after the use of tools orthosis
* There is a degree of curvature> 50 degrees in adults
Cause
A. Nonstructural: Scoliosis This type of reversible (can be restored to its original shape), and without rotation (rotation) of the backbone
a. Postural scoliosis: Caused by bad posture habits
b. Muscle spasm and pain, which may include:
(I) pain in spinal nerve roots: sciatic scoliosis
(Ii) Pain in the spine: may be caused by inflammation or malignancy
(Iii) Pain in the abdomen: appendicitis can be caused by
c. The difference between lower leg length
(I) Actual shortening
(Ii) Apparent shortening:
A. Nonstructural: Scoliosis This type of reversible (can be restored to its original shape), and without rotation (rotation) of the backbone
a. Postural scoliosis: Caused by bad posture habits
b. Muscle spasm and pain, which may include:
(I) pain in spinal nerve roots: sciatic scoliosis
(Ii) Pain in the spine: may be caused by inflammation or malignancy
(Iii) Pain in the abdomen: appendicitis can be caused by
c. The difference between lower leg length
(I) Actual shortening
(Ii) Apparent shortening:
1. Adduction contractures at the shorter leg side
2. Abduction contracture in the legs longer
B. Structural : Scoliosis this type is irreversible and the rotation of the spinea. Idiopathic (unknown cause): 80% of all scoliosis
(I) Infants: from birth - 3 years
(Ii) Children: 4-9 years
(Iii) Youth: 10-19 years (late infancy)
(IV) Adult:> 19 years
b. Osteopathic
(I) Congenital (acquired at birth)
1. Localized:
a. Failure of formation of the spine (hemivertebrae)
b. Failure of segmentation of the spine (unilateral bony bar)
2. General:
a. Osteogenesis imperfecta
b. Arachnodactily
(Ii) Learned
1. Fracture dislocation of the spine, trauma
2. Rickets and osteomalacia
3. Emphysema, thoracoplasty
c. Neuropathic
(I) Congenital
1. Spina bifida
2. Neurofibromatosis
(Ii) Learned
1. Poliomyelitis
2. Paraplegia
3. Cerebral palsy
4. Friedreich's ataxia
5. Syringomielia
Idiopathic scoliosis
Because scoliosis is idiopathic scoliosis most preachers overall, it will be discussed in more detail.
Incidence and Causes
* 0.5% of the population suffering from idiopathic scoliosis
* The disease can be inherited familial
* The pattern of bending (curve) can be:
o Thoracic
o Thoracolumbar
o Lumbar
o The combination of thoracic and lumbar
Additional examination
* Examination of basic importance is plain (roentgens) backbone that includes:
o Photo of existing AP and lateral standing position: this picture aims to determine the degree of bending of scoliosis
o facedown AP Photo
o Photo of bending force R and L: photo aims to determine the degree of curvature after bending
o pelvic AP Photo
* In certain circumstances such as the presence of neurological deficits, stiffness in the neck, or headache, an MRI examination can be done
1. Localized:
a. Failure of formation of the spine (hemivertebrae)
b. Failure of segmentation of the spine (unilateral bony bar)
2. General:
a. Osteogenesis imperfecta
b. Arachnodactily
(Ii) Learned
1. Fracture dislocation of the spine, trauma
2. Rickets and osteomalacia
3. Emphysema, thoracoplasty
c. Neuropathic
(I) Congenital
1. Spina bifida
2. Neurofibromatosis
(Ii) Learned
1. Poliomyelitis
2. Paraplegia
3. Cerebral palsy
4. Friedreich's ataxia
5. Syringomielia
Idiopathic scoliosis
Because scoliosis is idiopathic scoliosis most preachers overall, it will be discussed in more detail.
Incidence and Causes
* 0.5% of the population suffering from idiopathic scoliosis
* The disease can be inherited familial
* The pattern of bending (curve) can be:
o Thoracic
o Thoracolumbar
o Lumbar
o The combination of thoracic and lumbar
Additional examination
* Examination of basic importance is plain (roentgens) backbone that includes:
o Photo of existing AP and lateral standing position: this picture aims to determine the degree of bending of scoliosis
o facedown AP Photo
o Photo of bending force R and L: photo aims to determine the degree of curvature after bending
o pelvic AP Photo
* In certain circumstances such as the presence of neurological deficits, stiffness in the neck, or headache, an MRI examination can be done
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