Tuesday, July 25, 2017
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Scoliosis

Scoliosis

Scoliosis is a deformity of the spine. Normally it develops especially during the growth phase of the individual although we also have deformities that occur in adulthood. It is very important to monitor the growth phase because it is the time when we can act on it.

The causes are varied, may or may not be associated with diseases, although the most frequent is that it is not and that it occurs without a cause. It’s what we call idiopathic scoliosis. This idiopathic scoliosis has no explainable cause and is sometimes related to the genetic inheritance of our parents. In this inheritance the scoliosis that we have does not have to be similar to the one of our father or mother. That is, our mother can have very important scoliosis and we have minimal scoliosis. First advice, if you have scoliosis, watch your children’s back!

The deformity has two main characteristics. One is the most evident in x-rays and is that the spine is not straight but forms a curve (usually “s” shaped). The second is that the vertebrae are rotated about their axis. The latter may go unnoticed in the lower back because they produce less striking asymmetries. However, it is very striking when it occurs in the dorsal region of the spine because, as the ribs are attached to the vertebrae, rotation affects these protruding ribs in the shape of a hump.

Idiopathic scoliosis produces a deformity that will develop mainly during the growth period. That is why in this period (especially when we are going to give the spin) we must be more vigilant. In adulthood it can cause problems but certainly at a much slower rate. To evaluate how a curve progresses, comparing X-rays is important (do not throw old X-rays because we may need them!).

ScoliosisFrequently asked questions:

– Who should I go to if I think I have scoliosis?

If it is a minor, the first person to go to is our pediatrician. The pediatrician can tell us if it is a scoliosis or not. Once diagnosed the most appropriate is referral to the specialist. Specialists in scoliosis there are two mainly: The rehabilitating doctor and the surgeon dedicated to the spine (they can be traumatólogos or neurosurgeons). Both specialists are suitable for a first assessment. If scoliosis does not require surgical intervention (such as most), it is best to go to the doctor who specializes in rehabilitation. This specialist will be able to monitor the evolution and advise the best measures that we must take in each moment.

– Does scoliosis heal with exercise?

In the first place, if it is an idiopathic scoliosis we should not speak of disease, but of deformity. That is, we do not seek a cure but a correction of this deformity. Well, the exercise will not correct the deformity or reduce it. Moreover, no serious treatment is intended to correct the deformity because it simply can not (significantly) unless we undergo surgery. What do I do, do I have to operate? In most of the cases, no. What has to be done is to detect scoliosis in time to be able to slow the development of it.

By this I do not mean that the exercise is not important, because it is. Exercise will help us prevent back pain and live a healthy life, but it will not change the curve of scoliosis.

– How can I stop the development of scoliosis?

The specialist will be able to indicate the cases in which we must stop the development of scoliosis. In many cases, simple monitoring is sufficient and no specific treatments are required. When the curve needs to be braked because scoliosis is expected to grow, the only effective conservative treatment is the corset.

– How does the doctor know if my scoliosis is going to grow?

It is a complex subject but basically there are several data that indicate us. On the one hand, by the type of curve we can know the probability of evolving. On the other hand, comparing the evolution of the curve in successive physical and radiographic examinations putting it in relation to the skeletal maturity of the patient.

– When will my scoliosis grow?

In idiopathic scoliosis, the development of the curve is slowed down at the end of the growth stage. This is not entirely true because certain types of curves evolve into adulthood and need to be followed although usually much less narrow than during growth. Growth is slowed by girls about two years after the first rule. In children it is very variable. In any case, the medical specialist can determine with an X-ray the stage of growth in which we are.

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