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Scoliosis: Symptoms, Treatment and Surgery

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Scoliosis is a sideways curvature of the spine that most often is diagnosed in adolescents. While scoliosis can occur in people with conditions such as cerebral palsy and muscular dystrophy, the cause of most childhood scoliosis is unknown.


Most cases of scoliosis are mild, but some curves worsen as children grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.

Scoliosis Symptoms, Treatment and Surgery




Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to straighten severe curves.

Definition of scoliosis



Scoliosis must be distinguished from a scoliotic attitude. Scoliosis is a permanent deviation of the spine (spine) in the three planes of space (the three dimensions). The scoliotic attitude, on the other hand, results from poor posture, without twisting of the vertebrae and without deformation, and can be easily corrected.


Causes of scoliosis

Idiopathic scoliosis is scoliosis whose origin is unknown, it appears mainly during infancy or during adolescence. Some put forward a hereditary factor because it is not uncommon to see several members of the same family affected. This scoliosis is the most common, accounting for 70-80% of scoliosis.



Scoliosis can also be caused by a congenital malformation (which occurs from birth), or by a neuromuscular or bone disease (myopathy, poliomyelitis ...), Marfan's disease, etc. This is called secondary scoliosis.

Note that bad postures, the practice of sports, the wearing of a school bag too heavy, or an unbalanced diet are not involved in the occurrence of scoliosis.


Symptoms of scoliosis

Scoliosis is not always diagnosed at an early stage, as usual, it does not cause any particular pain. Back pain as well as observation of the spine can alert parents.

The visible sign is a malformation of the spine, an appearance of poor posture, and especially a bump on one side of the back when the child leans forward. This bump is called gibbosity.


Populations at risk

Although it can occur in adulthood, scoliosis mainly affects children and adolescents. Girls are more exposed than boys and the deviation of the spine is generally greater than in the latter: 80% of scoliosis appears in girls. 2-3% of adolescents have scoliosis, but it is really important in less than 1% of them.

Adolescence is a risky period, because scoliosis progresses slowly before adolescence, but can then evolve and worsen very quickly, due to rapid growth.


Diagnosis of scoliosis

One-shoulder that is slightly higher than the other may be enough to attract the doctor's attention. In order to fully appreciate the deviation of the spine, he asks the patient to stand bare-chested, feet together, in order to notice an asymmetry. Then he makes him lean forward, legs outstretched, to highlight the gibbosity, visible bump on one side of the spine.

With X-rays, scoliosis is explored to know the exact place where it is located and especially its angle. Because this angle will condition the treatment.


Treatment of scoliosis

Scoliosis treatment is a long-term treatment that takes place over several years. If the deviation of the spine is not very pronounced, scoliosis does not require any special treatment and should simply be followed especially in early adolescence where it can worsen very quickly. 

All sports are beneficial, especially swimming which leads to an extension of the spine. Physiotherapy is used, in order to maintain a good muscle condition, but it is not enough to prevent the aggravation of scoliosis. Muscle stimulation techniques by electrotherapy do not seem to give interesting results. Scoliosis should be treated in about 1 in 2 children, as soon as the angle of the deformation reaches 15 to 20 °. Wearing a corset helps to avoid aggravation and straighten the curvature. These corsets must be worn 24 hours a day, and are only removed for toileting. They should be worn until the bones of the vertebrae are mature and their shape fixed. Thus, they are no longer likely to deform.

In some cases, the treatment of scoliosis is surgical, especially when the curvatures worsen despite wearing the corset or the angle of deformation reaches 35 ° or more depending on the area of scoliosis. The operation can be performed in case of severe scoliosis of a very young child, or after the age of 10 years.

When treatment has not been performed before the end of growth, surgeons can operate on adults, but the operations are often heavier. Several types of surgical interventions are possible. We can sometimes treat the cause (a malformation of the vertebra, a deformity, an occipital hole too narrow ...). The surgeon can also attach vertebrae to each other to block them, by bone grafting, then puts in place metal rods with screws, in order to straighten the spine. This makes it possible to obtain from a straight spine, but stiff in one place, which is less disabling than a twisted spine.


Prevention of scoliosis

While it is true that a large number of scoliosis remain of unknown origin, it is possible to prevent their progression through early detection. Having your child examined regularly by a doctor, especially during growth, allows for rapid management.

It is especially important to follow very closely the detected and low-importance scoliosis, especially from the beginning of adolescence, in order to treat them as quickly as possible in case of need and avoid complications.


Complementary approaches to scoliosis

Osteopathy

There is no evidence of the effectiveness of osteopathy in the treatment of scoliosis. This does not mean that osteopathy should be avoided, which can help accompany medical treatment.

Pilates method

It can be interesting to fight against scoliotic attitudes, but can not be a treatment for scoliosis.

Lifestyle

It is necessary to adopt some good habits to promote the treatment of scoliosis. Among these, let us mention the regular practice of a sport. The ideal is to swim.


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