Text/Department of Orthopedics, Beijing United Family Hospital
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How to find scoliosis in children: take off the shirt, observe the child's back, if there is some degree of asymmetry, do not delay, please take the child to the hospital orthopedic department as soon as possible.
How doctors check for scoliosis: objective and quantitative methods, such as anterior flexion test, imaging tests, etc.
What are the effects of scoliosis: Poor posture. In severe cases, intractable pain, numbness in the lower extremities, abnormal bowel movements, and sometimes affect the cardiopulmonary system may occur.
How to prevent scoliosis scientifically: regular examination, daily monitoring by parents; scientific exercise to enhance spinal stability; correct posture, correct sitting and standing posture, backpack on back, avoid overweight school bags or shoulder bags.
How to rehabilitate scoliosis: non-surgical treatment, including exercise therapy, postural training, breathing training and electrical stimulation therapy; surgical therapy.
Whether it is necessary to wear braces: After a detailed examination, follow the doctor's advice.
Scoliosis is defined as a lateral curvature of the spine on the coronal surface, often accompanied by varying degrees of spinal rotation. As is customary, scoliosis is defined by a curvature greater than or equal to 10° (determined by cobb angle measurement).
The direction of curvature (left or right) of scoliosis is determined by the convex surface of the scoliosis. The location of the migraine is determined by the parietal spine (the body that deviates the farthest from the midline and rotates the most).
Unlike neuromuscular scoliosis, congenital scoliosis, or communic scoliosis, idiopathic scoliosis has no clear cause. Idiopathic scoliosis in adolescents is the most common idiopathic scoliosis, accounting for 80% to 85% of all cases.
How is scoliosis detected?
Many parents will have questions: how to find out if your child has scoliosis as soon as possible? Today I will teach you a trick, how to check the curvature of your child's spine at home.
It is best to take off your shirt and observe your child's back. Observe or use your fingers along the spinal spinous process from top to bottom to determine if your child has the following three problems:
1. Does the curve of the spine deviate from a straight line perpendicular to the ground?
2. Are the shoulder blades on both sides on the same level? Is the prominence consistent?
3. Is the distance between the arms and the waist line on both sides consistent?
If the results of these three problems are abnormal, that is, there is some degree of asymmetry in the child's back. Then, do not delay, take the child to the orthopedic doctor for further examination.
Most parents who visit the doctor find such features when bathing or taking pictures of their children, so parents should pay special attention to other functions such as their children's sitting posture and standing posture in their lives.
Image credit: bigstock
How does the doctor check for scoliosis?
In addition to careful observation, the doctor will also perform some objective and quantitative tests to check your child's scoliosis.
For example, a scoliosis ruler is used for screening on a forward flexion test. For example, the use of X-ray, MRI and other techniques to conduct detailed imaging examination of the bones and nerves of the spine.
What are the effects of scoliosis?
If the spine is deformed, abnormal forms such as shoulder and back unevenness, thoracic deformity, pelvic tilt, long and short legs, and poor posture may occur, and daily activities may be affected.
Severe scoliosis may also present with various stubborn pains, and even symptoms such as nerve damage, sensory impairment of nerve compression limbs, numbness of the lower limbs, and abnormal bowel and urine.
Scoliosis also affects the gas exchange of the respiratory cardiopulmonary system, including local ventilation, blood flow, ventilation and blood flow ratio, diffusion, etc., and is prone to breathing disorders such as shortness of breath and wheezing.
How to scientifically prevent scoliosis?
Regular examination: to prevent scoliosis, parents should take the first pass, daily monitoring of changes in children's body structure, especially the stage of height spike; you can also regularly go to professional institutions for physical examination screening, early detection, early treatment.
Scientific exercise: Children carry out scientific exercises in addition to learning, enhance physical fitness and function, and enhance spinal stability.
Correct posture: Pay attention to the child's daily sitting posture, standing posture and other daily life postures, and avoid sitting in a lazy or crooked sitting posture for a long time. Carry backpacks every day and avoid overweight school bags or shoulder bags.
How to carry out rehabilitation for scoliosis that affects your child's posture?
When treating scoliosis, there are many factors to consider, such as the child's age, gender, degree of scoliosis, growth potential, and so on.
Therefore, estimates of scoliosis development are based on an assessment of bone development maturity to determine the risk of scoliosis progression.
Risser's sign is a visual grading of the degree of ossification and fusion of the iliac crest epiphyseal plate that can be used to assess the maturity of bone development during post-anterior spinal x-ray examination. The lower the risser rating, the greater the residual growth potential and the higher the risk of scoliosis progression.
In simple terms, when the scoliosis angle is between 11-29 degrees, the development of scoliosis can be dynamically observed while performing physical therapy and muscle balance training.
When the scoliosis angle is greater than 30 degrees, it is recommended to use a brace for treatment.
Non-surgical treatment
Non-surgical treatments include exercise therapy, electrical stimulation, tuina, suspension traction, braces and American chiropractic.
Early treatment is a basic principle of scoliosis treatment and is recommended to be used in a timely and appropriate manner. The appropriate correction method can be selected based on the patient's age, scoliosis severity, and progression.
Warning: Do not believe that you can rely on manual treatment to give a reduction and straightening of the convex spine!
1. Exercise therapy
At the heart of exercise therapy is to strengthen the concave muscles and counter the stretching power of the convex muscles.
Including three-dimensional exercise therapy, axial spine weight loss training, lateral movement exercise, suspension exercise, quantitative torso rotational strength training, torso stability training, individual function training, etc.
However, in some patients, the muscles on the convex side will be relatively stronger in the early stage because the muscles on the convex side of the scoliosis are more active than on the concave side.
2. Posture training
Consciously strengthen the training of convex muscles and reduce the antagonistic muscle contraction response produced by the concave muscles.
3. Respiratory training and electrical stimulation therapy
Electrical stimulation acts on the relevant muscle groups on the convex side of the scoliosis, causing it to contract and produce a corrective force for scoliosis.
Parents ask: Is it necessary to wear braces?
Doctors say that doctors find that the degree of scoliosis is moderate (25 to 40 degrees) or that the patient's condition is progressive (the bending becomes more and more severe), and the brace is usually the first-line treatment option. Braces do not have a significant effect on fully developed bones, so they are generally only used in patients who have not stopped developing.
Braces can be divided into two types: soft braces and hard plastic braces.
Doctors decide which brace a patient must use based on several factors, including the degree and position of the bend, as well as the patient's age and activity level.
Patient sex is also important because girls are at higher risk of developing the disease than boys.
Some braces only need to be worn at night when sleeping, while others must be worn 23 hours a day. The brace must be worn as directed by your doctor to ensure that it functions.
Surgical treatment
Patients requiring surgical correction include immature patients with bones with a cobb angle of at least 50°, and some patients with immature bones with a cobb angle of 40°-50°.
Patients with mature bones at a cobb angle of at least 50° may also have the option of surgical correction. Patients with lumbar scoliosis with significant trunk displacement may also require surgery.
summary:
1. Cobb angle < 25°:
Close observation, if the progression is >5° per year and the cobb angle > 25°, bracing should be performed.
2. Cobb angle between 25° and 40°:
Brace therapy should be performed, and surgical treatment is recommended if the progression is >5° per year and the cobb angle is > 40°;
3. Cobb angle between 40° and 50°:
Since the scoliosis is greater than 40°, the chance of progression is high, and if the patient is immature, surgery should be recommended.
In mature patients, surgery should also be performed if the flexural curvature of the migrave is greater than 50° and follow-up reveals significant progression of the scoliosis;
4. Cobb angle >50°:
Surgery should be taken.
#Scoliosis Correction ##脊柱矫正 #