Scoliosis

Scoliosis is the abnormal side to side curvature of the spine. When viewed from behind, a normal spine should appear straight but the spine of a person suffering from scoliosis will show varying degrees of curvature. A person with scoliosis can have 1 or 2 curves to the spine, giving the appearance of either a "C" or "S" shaped spine.

Causes of Scoliosis:

Congenital - caused by bony abnormality at birth
Idiopathic - the most common type of scoliosis, idiopathic scoliosis appears during development with no known cause
Degenerative - this can be the result of natural degenerative changes or traumatic injury to the spine
Neuromuscular - the result of muscle or nerve abnormalities that can lead to imbalance of the spine.

Self-detection fact sheet

Cobb angle

< 20° elevated shoulder; paraspinal muscle imbalance and tightness
20°-40° change of alignment of thoracic, with concave side muscle spasm
>40° severe spinal mal-alignment; cardiopulmonary function would be affected if conditions get worse which is life-threatening

Facts about scoliosis in children every parent should know

A curve in the spine may get worse as your child grows, so it is important to find any problem early. Scoliosis most often causes no symptoms in your child until the spinal curve becomes large.

Simple examination

Parents can ask their child to lean forward with his or her feet together and bend 90 degrees at the waist. The examiner can then easily view from this angle any asymmetry of the trunk or any abnormal spinal curvatures.

You might also notice these early signs:

Your child has one shoulder or hip that looks higher than the other.
Your child's head does not look centered over the body.
Your child has one shoulder blade that sticks out more than the other.
Your child's waistline is flat on one side, or the ribs look higher on one side when your child bends forward at the waist.

The goal of treatment for scoliosis is to prevent the spinal curve from getting worse and to correct or stabilize a severe spinal curve. The number of degrees helps the doctor decide what type of treatment is necessary. A scoliosis curves that are less than 20 degrees usually need to have regular checkups until pubertal maturation and growth are complete. If the curves are 20 to 40 degrees, the orthopedist will generally suggest a back brace. A Cobb angle of 40 degrees or more may mean that surgery is necessary.

Surgical operation: with the advancement of internal fixation technique and biomechanics, the risk of operation is reduced. However, post-operation complications such as limited spinal movements, muscles atrophy, osteoporosis, osteophytes, etc. are still encountered.

Physiotherapy: Stretching exercise, muscle strengthening exercise and breathing exercise assigned by physiotherapist would help reduce recurrence and minimize complications.

Spine and Physiotherapy adjustment: Spine and Physiotherapist would correct the mal-aligned spine by means of biomechanical lever concepts.

Back orthosis: Daily use can prevent scoliosis from fast-worsening

Treatment and care

脊椎側彎通常在兒童期或青春期的成長過程中發現。對於仍在成長的兒童，可以使用外部軀干支具來防止在兒童成長過程中脊椎側彎進一步惡化。所以愈早開始接受治療愈可以更有效控制脊骨側彎的情況，減慢惡化的速度。很多延誤治療的患者於長大後會更容易引起其他痛症，甚至乎影響外觀，造成一定程度的心裡影響，所以及早為脊椎側彎檢查及治療是非常重要的。