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Scoliosis
is a lateral curvature of
the spine (backbone), causing it to have more of an "S" or "C" shape rather than a straight line down the back (because of the abnormal curve from side to side). It is usually accompanied by a twisting or rotational deformity of vertebrae.
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- Scoliosis is usually painless. In the early stages, the curve is too subtle to be noticed. The common symptoms are as follows:
- One shoulder appears to be higher than the other.
- Uneven pelvis
- Protruding shoulder blades
- Fatigue after prolonged sitting or standing
- Dull back pain or breathing difficulty can occur in severe scoliosis.
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- The most common form of scoliosis is 'idiopathic' (over 80% of the cases), meaning the cause is unknown. Most idiopathic scoliosis occurs in middle to late childhood from the ages of 10-18.
- Most cases of idiopathic scoliosis have genetic tendencies.
- In other instances, scoliosis may occur secondary to underlying disorders, such as poliomyelitis, Cerebral Palsy, congenital abnormality (especially hemivertebrae), spina bifida, or progressive muscular dystrophy.
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A diagnosis is based on physical examination and X-rays of the spine. Spine X-rays are used to assess the degree and severity of scoliosis, and to identify any other spinal abnormalities.
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- Treatment is determined by the degree of the curve, the type of scoliosis, and age. Common measures:
- Observation -- if the curve is minimal (less than 20 degrees), no treatment is required. Follow-up of the scoliosis is needed every 6 months.
- Back brace -- for spinal curves of 20 to 40 degrees, a brace is helpful in preventing the progression of the scoliosis, but does not correct the existing curve.
- Surgery -- surgery is recommended for severe scoliosis (over 40 degrees) to correct the curve and stabilize the spine. The spine is straightened by fusing the vertebrae, and is supported with instrumentation and device.
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The prognosis depends on the sex, onset age, the initial degree of curve, and the underlying disease process.
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