Monday, December 19, 2005


Every person's spine curves. A certain amount of curvature is necessary for people to balance, move, and walk properly. But three people out of 100 have a condition that causes the spine to curve too much in the wrong direction. This condition is called scoliosis (pronounced sko-lee-o-sus). The name comes from the Greek word "skoliosis," which means curvature.

What Is Scoliosis?
Scoliosis is sort of a medical mystery - no one knows what causes the most common form of scoliosis, idiopathic scoliosis. (Idiopathic is a medical term that means it's not known what caused the condition or disease.) The condition can be hereditary, so a person who has scoliosis may have family members who have it. Girls are much more prone to developing severe cases of spinal curvature than boys are: Teenage girls over the age of 9 are five times more likely to be diagnosed with the condition than boys of the same age.

Many times, a person with scoliosis has been developing the condition since childhood. But because scoliosis can develop very gradually, in most cases it isn't diagnosed until a person is between the ages of 10 and 14. In scoliosis, the spine becomes abnormally curved from side to side into an "S" shape. When the curve gets severe, it can be visible and cause discomfort. If the curve gets really severe, it can even affect a person's breathing and heart function and can lead to damage in the joints of the spine and pain in adulthood.

How Is Scoliosis Diagnosed?
Some teens have visible signs of scoliosis. Sometimes a curvature of the spine is obvious or one shoulder blade is noticeably higher than the other one. Other times, though, it's not so obvious. And because scoliosis doesn't hurt or happen suddenly, it's not always easy to diagnose.

Some schools in the United States test for scoliosis. But the most accurate diagnosis is done by a doctor. Doctors routinely check teens for scoliosis during regular physical exams.

What Do Doctors Do?
After examining you closely, the doctor will decide if further treatment is needed. If he or she determines the curve isn't a problem, you may not need any treatment - just regular checkups to make sure the curve doesn't become larger. If the doctor wants to get a clearer view of your spine, he or she may order X-rays. If the doctor's exam or X-rays show a significant curvature, you'll be referred to an orthopedist.

Orthopedists, also known as orthopedic surgeons, are doctors who have had specialty training in the way the skeletal system functions and what can go wrong. They are skilled in making decisions about how to treat conditions like scoliosis. The orthopedist will examine you and study X-rays of your spine.

You may hear the orthopedist mention the Cobb angle. The Cobb angle is a measure of the curvature of the spine in degrees, and the number of degrees helps the doctor decide what type of treatment is necessary. A scoliosis curve of 10 to 15 degrees usually means that nothing needs to be done, except for regular checkups until pubertal maturation and growth are complete (the curvature of the spine usually doesn't get worse after that point). If the curve is 20 to 40 degrees, the orthopedist will generally suggest a back brace. A Cobb angle of 40 or 50 degrees or more may mean that surgery is necessary.

Treating Scoliosis
About one in five teenagers with scoliosis needs to wear a back brace, and luckily, these braces are becoming better and better all the time. Teenagers who had scoliosis about a hundred years ago didn't have very comfortable options. In the beginning, patients were strapped to racks and their bodies were pulled every which way. Later, metal jackets were worn in an effort to straighten the curve, but these weighed about 30 pounds apiece. Eventually, simpler back braces were invented, but they still had to be worn almost all the time. Today's braces are better still: They do not always need to be worn full time. Braces are worn by about 20% of kids with scoliosis, and most kids only need to wear them for 18 to 20 hours a day. Many of them are constructed of lightweight materials. Several different types of braces are used, and the one that the orthopedist chooses depends on the teenager and the severity of the curvature. Some of the most frequently used braces include:
  • TLSO. This stands for thoracic-lumbar-sacral-orthosis, and depending on where you live, it may be called the New York, Wilmington, Boston, or Miami brace. This is a low-profile brace, which means it comes up under the arms. This brace is very comfortable, but it's not right for every person with scoliosis.
  • Wilmington jacket. This brace was developed at the Alfred I. duPont Hospital for Children in Wilmington, Delaware. It's constructed of lightweight plastic and can be worn under clothes, so it isn't visible.
  • Charleston brace. This is also a low-profile brace, and it bends the spine in an effort to straighten the curve as much as possible to prevent the curve from worsening. This brace puts the wearer's body in an awkward position, though, so it can only be worn while sleeping.

Whichever brace is used, its function is the same: The brace acts as a holding device that keeps the spine from developing more of a curve. A brace won't ever make the spine straight, but if it does its job well, the curve won't increase more than 5 or 10 degrees.

Sometimes, even with a brace, surgery becomes necessary to correct the curvature of the spine. (About one or two out of every 10 teenagers with scoliosis must undergo surgery.) During the operation, the orthopedic surgeon removes tiny pieces of bone from the patient's pelvis (hipbone) and puts them in between the vertebrae in the spine to provide stability and prevent further side-to-side curving of the spine. The surgeon also uses metal rods, hooks, and wire to keep the spine straight until the bits of bone join together with the vertebrae.

The surgery usually takes between 3 and 4 hours. The patient is usually home within 1 week, and after 3 or 4 months, he or she can take part in most regular activities. After 6 months, the person can return to almost all activities, and after 1 year, he or she can return to contact sports.

After about a year, the bone fusion will be complete. The rods placed in the back during surgery don't limit movement much - it's still possible to bend down and move all different ways. The rods are left in the patient's back, but only because taking them out would involve another operation, which isn't necessary.

With the right kind of treatment - whether it involves a brace or surgery - almost every teen with scoliosis can have an active, normal life!



Nape tetiba aku cite pasal skoliosis? ;)