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Did you ever wonder what the doctor was looking for when checking your back during your annual exam?

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Title: Did you ever wonder what the doctor was looking for when checking your back during your annual exam?


1
Did you ever wonder what the doctor was looking
for when checking your back during your annual
exam?
2
Questions to Ponder
  • What is Scoliosis?
  • What is Adolescent Idiopathic Scoliosis (AIS)?
  • How do I know if I have AIS?
  • Is AIS caused by not drinking enough milk or poor
    posture?
  • Are girls more likely to have scoliosis than
    boys?
  • Is AIS hereditary?
  • What are the treatment options for AIS?

3
A View of Adolescent Idiopathic Scoliosis (AIS)
  • by
  • Tosha S. Rhea

4
Overview
  • What is Scoliosis
  • Prevalence of Scoliosis
  • Adolescent Idiopathic Scoliosis (AIS)
  • Pedigree Chart
  • Symptoms of AIS
  • AIS Testing
  • AIS Treatment
  • Observation
  • Bracing
  • Surgery
  • Concluding Thoughts

5
What is Scoliosis?
  • Straight Spine
  • -has 0 curve
  • Curvature of the Spine
  • -has a curve that is between 0 and 10
  • Scoliosis of the Spine
  • -has a curve that is greater than 10
  • An abnormal lateral curve to the vertebral column
    greater than 10
  • Many different forms of scoliosis

6
Prevalence of Curvature/Scoliosis
  • Curves 10 or less, 3-5 out of 1,000 people
  • Curves less than 20 is equal in males and
    females
  • Overall, 2 of females and 0.5 of males are
    affected by scoliosis

7
Adolescent Idiopathic Scoliosis (AIS)
  • Side-to-side curve
  • Greater than 10
  • Twisting of the spinal column
  • Spine resembles a C
  • or S
  • Patients are between 10 and 18 years
  • Curve gets larger during rapid growth
  • Otherwise, patients are healthy
  • No known cause
  • 30 have some family history
  • Genetic connection

8
Pedigree Chart with Multiple Family Members
affected with AIS
Closed symbols represent affected individuals
Squares - Males Circles - Females
Suggests a dominant mode of inheritance
9
Symptoms of Scoliosis
One shoulder may appear higher
The body may tilt to one side
One side of the rib cage may appear higher
One leg may appear shorter than the other
Waist may appear uneven or hips elevated
10
AIS Testing
  • Adams Forward Bend
  • X-ray
  • This test involves the student bending forward
    with arms stretched downward toward the floor and
    knees straight. This angle most clearly shows
    any asymmetry in the spine and/or trunk. Often
    preformed in school starting in the fifth grade.
  • This procedure is needed to confirm the AIS
    diagnosis, to check the magnitude of the curve,
    and to check the skeletal maturity of the
    patient. This will influence the treatment
    decisions.

11
AIS Treatment
  • Observation
  • Bracing
  • Surgery

12
Observation
  • Consider patients age
  • (girls grow rapidly until age 14, boys until
    age 16)
  • Consider status of females 1st menstrual period
  • (growth slows down)
  • Consider x-ray of the spine and pelvis
  • (shows skeletal maturity on a scale of 0 to 5)

13
Bracing
  • Used with curves between 25 and 40
  • during the growth phase
  • Designed to each patients shape
  • Prevents curve progression
  • Worn under clothes
  • Worn all day or just at night
  • Worn until growth of the spine has stopped

14
Surgery Treatment with Spinal Fusion
  • Harrington Method
  • Contrel-Dubousset Instrument
  • Fusion with one rod hooked to the spine
  • Obsolete flatback
  • Increase wear and tear
  • Early onset of arthritis
  • Degeneration of discs
  • Muscle stiffness
  • Reliance of painkillers
  • Further surgery required
  • Disability
  • Fusion with a combination of two rods, screws,
    hooks, and wires
  • Modern
  • Low rate of failure
  • 5-7 Day hospital stay
  • 3-4 Weeks out of school
  • 6 Month recovery time
  • For more information go to
  • Scoliosis Research Society (SRS)

15
Concluding Thoughts
  • Scoliosis occurs relatively frequently in the
    general population. Its frequency depends upon
    the magnitude of the curve of the spine.
    Scoliosis of greater than 25 degrees occurs in
    many people all around the world. However, 60
    of curvatures in rapidly growing pre-pubertal
    children will progress. Screening for Adolescent
    Idiopathic Scoliosis (AIS) is not necessary
    until the fifth grade, and beyond that point,
    boys and girls should have an examination every
    6-9 months. It is important to know what to do
    if a patient already has scoliosis, and what
    treatment options are available.

16
Resources
  • www.srs.org
  • www.ejbjs.org
  • www.journals.lww.com/corr/Abstract/2000/03000/Idio
    pathic_Scoliosis
  • www.en.wikipedia.org/wiki/Scoliosis
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