According to the survey, the rate of poor posture of children and adolescents in Shenzhen is 47.91%, of which the scoliosis rate is 1.67%. In the "Adolescent Posture Abnormality Screening and Prevention Series Activities" held on April 13, Zhou Wenyu, chief physician of the Spine Department of Shenzhen Second People's Hospital, introduced, "In the screening of adolescent posture abnormalities, we found that neck probing and hunchback accounted for 46.1%, slump and bent back accounted for 23.6%, shoulders irregularity accounted for 20%, and plantar problems accounted for 18.3%. ”
Zhou Wenyu emphasized at the event that early scoliosis is not easy to detect among adolescents with abnormal posture, especially when the child is wearing clothes. According to statistics, nearly 40,000 primary and secondary school students in Shenzhen have been diagnosed with scoliosis, and more than 5 million primary and secondary school students in the country have scoliosis, and the number is increasing at a rate of about 300,000 per year. Scoliosis has become the third biggest "killer" of children and adolescents in mainland China after obesity and myopia.
In order to avoid "detours" for teenagers, Shenzhen has been regularly providing free scoliosis screening for teenagers, opening adolescent spine health centers, and setting up corresponding service stations in various districts.
▲Therapists are helping teenagers with scoliosis rehabilitation training.
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Ms. Huang, who lives in Bao'an District, also paid attention to the phenomenon of adolescent scoliosis from the school's information, her child is in the second year of junior high school, and she has the impression that the school has a scoliosis screening every year. Since then, I have always told my children to pay attention to their daily habits. ”
In 2021, nearly 1.02 million primary and secondary school students were screened in school scoliosis screening in Shenzhen, and 39,000 scoliosis were found, with a prevalence rate of 3.86%. When an adolescent is diagnosed with scoliosis, specific intervention and treatment are required depending on the severity.
In the scoliosis clinic of Nanshan Hospital, which was officially opened a few days ago, Li Xialin, deputy chief physician in charge of the outpatient clinic, introduced in an interview with the media that scoliosis is a common spinal deformity, and from the back, the spine of a normal person is a straight line. Scoliosis refers to the curvature of the spine in a "C" or "S" shape during development, and the curvature angle of the spine is medically defined as scoliosis.
Scoliosis can occur in early childhood, adolescence, adolescence, and adulthood. The rapid development of the human body during adolescence is also the stage when scoliosis is prone to serious deterioration, so idiopathic scoliosis in adolescence has become the focus of research in various medical institutions. If not detected and treated in time, the effects will continue into adulthood and old age. The reasons for its occurrence are also related to the heavy academic workload, improper sitting posture and lack of exercise among adolescents, but there are many causes of scoliosis, and the most effective way is early prevention, early detection and early intervention.
In July 2022, a young girl with scoliosis in Shenzhen underwent the first minimally invasive surgery for scoliosis non-fusion VBT (Vertebral Body Tethering) in mainland China at the University of Hong Kong-Shenzhen Hospital. In 2020, the little girl was found to have scoliosis during the school screening, which was 6° at the time, and the next year it was checked again, and the degree worsened to 12°. The parents noticed, but they thought that the degree was not so serious, and they thought that they would wait until the high school entrance examination to make plans, and then in the second year, it was obvious that the spine was bent to one side, becoming an S-shape, and the most curved point was 63 degrees, when she was 11 years old.
It has reached the point where surgical intervention is necessary - in the conventional treatment of scoliosis, it is necessary to observe it regularly when it is less than 10°, 10° to 20° requires physical training and regular follow-up, between 20° and 45° it requires regular follow-up with a brace, and when it is greater than 45°, surgical treatment is already required. And it is better to intervene and treat early, because during the growth of adolescents, the spine is also developing. For adolescents at peak development, if no intervention is performed, the degree of scoliosis usually increases by about 1 degree per month.
The little girl saw an immediate improvement after the surgery, and she was pleasantly surprised to find that she had "grown" 5 centimeters taller, and when she returned to school, she could run and jump as usual. There are also examples on the Internet where timely intervention and treatment are not achieved, which leads to changes in appearance and has an impact on real life. In order to pay attention to, prevent and intervene in the impact of scoliosis on adolescents, it depends on the strength of all aspects.
▲X-ray of a 5-year-old child's scoliosis.
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In the link of "early detection", Shenzhen is at the forefront. The Shenzhen Municipal Government has long been aware of the problem of adolescent scoliosis and launched the Scoliosis Screening Program for Primary and Secondary School Students in Shenzhen in September 2013. Under the leadership of the Shenzhen Municipal Education Bureau and the Shenzhen Municipal Health Commission, the city began to screen primary and secondary school students for scoliosis.
According to the "2013-2030 Shenzhen Adolescent Scoliosis Research Report" in the "Shenzhen Women and Children's Development Report (2020)", Shenzhen has carried out efforts to strengthen the screening and prevention of adolescent spine health in many aspects. First of all, in terms of policy, in November 2018, the Shenzhen Municipal Government approved the implementation of the "Shenzhen Public Health Service Strengthening Action Plan", which clearly states in Article 5: "Strengthen the prevention and intervention of key health problems such as myopia, obesity, malnutrition, dental caries, and scoliosis." By the end of 2018, a comprehensive prevention and treatment platform for myopia in children and adolescents and a platform for the prevention and treatment of major diseases of scoliosis in adolescents will be built. ”
Secondly, in terms of institutional platform construction, the Shenzhen Adolescent Spine Health Center was established in the Second People's Hospital of Shenzhen, and took the lead in organizing a collaborative work network for the comprehensive prevention and control of adolescent scoliosis.
In terms of screening, since the launch of scoliosis screening, more than one million people have been screened, and some adolescents with more serious scoliosis have been referred for treatment in a timely manner.
At present, primary and secondary school students aged 10 to 17 in Shenzhen can be tested free of charge at school, at the Shenzhen Youth Spine Health Center, physical fitness measurement and sports health guidance stations in various districts, designated hospitals and community health service institutions. After screening, patients who are determined to have abnormal posture can make an appointment on the mini program of Shenzhen Adolescent Spine Health Center, and then go to the service station to receive intervention.
The newly opened scoliosis clinic will conduct a comprehensive analysis and make a definitive diagnosis based on the patient's imaging results, customize a personalized treatment plan on this basis, arrange follow-up, regularly monitor the condition, adjust the treatment plan in time, and consolidate the treatment effect.
▲The first two years of bone age closure are the golden correction period for scoliosis.
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The reporter learned that in Shenzhen, in addition to the outpatient clinics of specialized hospitals specializing in scoliosis, there are also some rehabilitation studios for posture correction, scoliosis correction, musculoskeletal pain rehabilitation, etc., such as Rebody posture and sports rehabilitation center. Li Xiaole, the head of the center, has been engaged in the rehabilitation industry for 9 years, and she told reporters that Rebody has received and treated many adolescents and adults with scoliosis, and the vast majority of scoliosis comes from genetics, and there are also acquired habits.
"The youngest patient we have recently received is a 5-year-old boy with 10° scoliosis. Li Xiaole said that in the long run, mild scoliosis does not have much impact on the body, including adults, and does not affect their lives, and for women, it will not affect their fertility. However, severe scoliosis can compress the internal organs and nervous system, causing symptoms such as low back pain and difficulty breathing.
Regarding the best treatment period for adolescent scoliosis, Li Xiaole said that the first two years of bone age closure are the golden correction period for scoliosis, and she recommends that it be done together with professional braces and training. Wearing a brace can control or delay the worsening of scoliosis, and for idiopathic scoliosis, early wearing of an orthopedic brace is expected to correct the deformity.
"Every therapist will have a different approach, and the brace technician, like us physiotherapists, is all manual work. Li Xiaole made an analogy: "Just like a tailor who makes clothes, the brace master is the spirit of craftsmanship and needs to be tailor-made, and now good brace masters in China are very scarce, so the teenagers who come to us for treatment, we will suggest that after they are equipped with a brace, we will provide physical training to assist in the correction of scoliosis." To put it bluntly, the purpose of treatment at this stage is to hope that his bones can grow back, while the purpose of treatment for adults is completely different from that of teenagers, and it is more for the surface of the body and the control of muscles."
Since its establishment in 2019, Rebody has seen a significant number of scoliosis patients, with a greater proportion of adults than teenagers. "Many people say that in adulthood, the degree of scoliosis cannot be adjusted, and orthopedic surgeons in many hospitals do not accept adults unless they have surgery. But this is not the case, if he does not intervene in adulthood, then his whole person will become more and more crooked, and his muscles will become more and more tilted. Li Xiaole suggested using physical therapy to loosen the patient's ribs, so that he is more flexible and his muscles more stable, so that he will be more balanced. If the patient's body surface is not visible as much as possible, the patient's body can maintain the middle positioning, and the spine can be stretched well, so as to avoid the possibility of aggravation in the future and reduce the tendency of his spine to become worse.
What exactly causes scoliosis? Li Xiaole said: "This is really a problem in the world, but genetics accounts for a large reason. Li Xiaole once received a family of scoliosis patients, and in terms of the ratio of men to women, she said that scoliosis mostly occurs in women. "Men have stronger joint ligament muscles, while women are more flexible, with looser ligaments and more prone to scoliosis. ”
In recent years, the incidence of scoliosis in Chinese children has shown a significant upward trend, in addition to genetic reasons, what are the other reasons? Li Xiaole said that when we were children, we had a lot of outdoor activities and had more opportunities to get close to nature, but now children go out by car, change from one room to another, and rarely exercise, which will affect the stability of the child's torso. Most families in Shenzhen are affected by the living area, and the child will be unable to perform in the crawling stage, resulting in a lack of coordination of the torso, which is more likely to cause scoliosis.
In addition, Li Xiaole suggested that parents should not give their children special training too early, such as golf, badminton, etc. "Because each movement of the special training is single, it will cause the rotation and tilt of the body, because it is always the same movement, but it is not good. Before the child's bones are fully grown, he should do more functional training, such as stretching, running and other aerobic cardiopulmonary coordination stability training, so that the child's physical function is good, and he can practice anything easily, which is what everyone calls talent. ”
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In the prevention of scoliosis, Zhou Wenyu, chief physician of the Department of Spine of Shenzhen Second People's Hospital, also shared a method of self-testing at home, "A very important and effective self-examination method is to conduct a forward bending test - let the child put his feet together, his knees straight, his torso bent forward 90 degrees, his hands naturally droop, and his hands are pointed to the toes, parents can touch the child's spine with their fingers from the back, slide down naturally from the cervical spine to the lumbar spine, feel the curvature of the spine, and observe whether the horizontal tangent line of the back and waist on both sides is of equal height." If the sides of the spine are not equal in height, it is advisable to go to the hospital for further examination. ”
To ensure the healthy growth of teenagers is multifaceted, a primary school mathematics teacher in Shenzhen teacher Feng said that as a teacher, in addition to paying attention to students' homework, in fact, the physical health of students is more important, "but the whole class of dozens of students, can not do every moment everyone can be stared at, there is a student who does not sit properly in homework, see it will definitely be reminded, but sometimes it is really not visible." She lamented that in the process of healthy development of adolescents, schools and teachers, parents, the public, etc., every link is indispensable, and only if everyone pays enough attention to it, can we prevent, detect and intervene in the healthy development of young people, so that teenagers can "straighten their backs".
Source | Crystal APP
Reporter: Xu Daiqian Zhang Yuchun
Photo: Courtesy of the interviewee
Editor: Ye Hui