Scoliosis is a medical condition in which a person's spine has a sideways curve. The cause of most cases is unknown, but is believed to involve a combination of genetic and environmental factors. Treatment depends on the degree of curve, location, and cause. People who have reached skeletal maturity are less likely to have a worsening case. Recent longitudinal studies reveal that the most common form of the condition, late-onset idiopathic scoliosis, causes little physical impairment other than back pain and cosmetic concerns, even when untreated, with mortality rates similar to general population.
The many causes of scoliosis include spinal deformities, neuromuscular problems, and inherited diseases or conditions caused by the environment. Idiopathic scoliosis represents a majority of cases, but its causes are largely unknown. Recent studies indicate potential heritability of the disorder. At least one gene, CHD7has been associated with the idiopathic form of scoliosis.
Adolescent idiopathic scoliosis has no clear causal agent, and is generally believed to be multifactorial. Congenital scoliosis can be attributed to a malformation of the spine during weeks three to six in utero due to a failure of formation, a failure of segmentation, or a combination of stimuli.
Secondary scoliosis due to neuropathic and myopathic conditions can lead to a loss of muscular support for the spinal column so that the spinal column is pulled in abnormal directions. Some conditions which may cause secondary scoliosis include muscular dystrophyspinal muscular atrophypoliomyelitiscerebral palsyspinal cord trauma, and myotonia.
Scoliosis associated with known syndromes is often subclassified as Escoliosis definicion yahoo dating scoliosis". Another form of secondary scoliosis is the degenerative scoliosis which develops later in life secondary to degenerative may or may not be associated with aging changes. This is a type of deformity that starts and progresses because of the collapse of the vertebral column in an asymmetrical manner.
People who initially present with scoliosis undergo physical examination to determine whether the deformity has an underlying cause and to exclude the possibility of underlying condition more serious than simple scoliosis.
The person's gait is assessedwith an exam for signs of other abnormalities e. When a person can cooperate, he or she is asked to bend forward as far as possible. This is known as
Escoliosis definicion yahoo dating Adams Escoliosis definicion yahoo dating bend test  and is often performed on school students.
If a prominence is noted, then scoliosis is a possibility and an X-ray may be done to confirm the diagnosis. As an alternative, a scoliometer may be used to diagnose the condition. Full-length standing spine X-rays are the standard method for evaluating the severity and progression of the scoliosis, and whether it is congenital or idiopathic in nature.
In growing individuals, serial radiographs are obtained at 3- to month intervals to follow Escoliosis definicion yahoo dating progression, and, in some instances, MRI investigation is warranted to look at the spinal cord.
The standard method for assessing the curvature quantitatively is measuring the Cobb anglewhich is the angle between two lines, drawn perpendicular to the upper endplate of the uppermost vertebra "Escoliosis definicion yahoo dating" and the lower endplate of the lowest vertebra involved.
For people with two curves, Cobb angles are followed for both curves. In some people, lateral-bending X-rays are obtained to assess the flexibility of the curves or the primary and compensatory curves. Congenital and idiopathic scoliosis that develops before the age of 10 is referred to as early-onset scoliosis. Scoliosis is defined as a three-dimensional deviation in the axis of a person's spine. Scoliosis has been described as a biomechanical deformity, the progression of which depends on asymmetric forces otherwise known as the Hueter-Volkmann Law.
The traditional medical management of scoliosis is complex and is determined by the severity of the curvature and skeletal maturitywhich together help predict the likelihood of progression.
The conventional options for children and adolescents are: For adults, treatment usually focuses on relieving any pain: Severe curvatures that rapidly progresses may be treated surgically with spinal rod placement.
Bracing may prevent a progressive curvature, but evidence for this is not very strong. In all cases, early intervention offers the best results. A growing body of scientific research testifies to the efficacy of specialized treatment programs of physical therapy, which may include bracing. A number of specific exercises or physiotherapy may be useful. Bracing is normally done when the person has bone growth remaining and is, in general, implemented to hold the curve and prevent it from progressing to the point where surgery is recommended.
Braces are sometimes prescribed for adults to relieve pain related to scoliosis. Bracing involves fitting the patient with a device that covers the torso; in some cases, it extends to the neck. The most commonly used brace is a TLSOsuch as a Boston Escoliosis definicion yahoo datinga corset -like appliance that fits from armpits to hips and is custom-made from fiberglass or plastic.
It is sometimes worn 22—23 hours a day, depending on the doctor's prescription, and applies pressure Escoliosis definicion yahoo dating the curves in the spine.
The effectiveness of the brace depends on not only brace design and orthotist skill, but also patient compliance and amount of wear per day. The typical use of braces is for idiopathic curves that are not grave enough to warrant surgery, but they may also be used to prevent the progression of more severe curves in young children, to buy the child time to grow before performing surgery, which would prevent further growth in the part of the spine affected.
However, these are guidelines and not every person will fit into this table. Scoliosis braces are usually comfortable, especially when well designed and well fitted, also after the 7- to day break-in period.
A well fitted and functioning scoliosis brace provides comfort when it is supporting the deformity and redirecting the body into a more corrected and normal physiological position. Evidence supports that bracing prevents worsening of disease, but whether it changes quality of life, appearance, or back pain Escoliosis definicion yahoo dating unclear.
Surgery is usually recommended by orthopedists for curves with a high likelihood of progression i. Surgeons who are specialized in spine surgery perform surgery for scoliosis.
To completely straighten a scoliotic spine is usually impossible, but for the most part, significant corrections are achieved. One or both of these surgical procedures may be needed.
The surgery may be done in one or two stages and, on average, takes four to eight hours. A year follow-up study published in the Journal of the American Medical Association asserted the lifelong physical health, including cardiopulmonary and neurological functions, and mental health of idiopathic scoliosis patients are comparable to those of the general population.
Scoliosis that interferes with normal systemic functions is "exceptional"  and "rare", and "untreated [scoliosis] patients had similar death rates and were just as functional and likely to lead productive lives 50 years after diagnosis as people with normal spines".
Generally, the prognosis of scoliosis depends on the likelihood of progression. The general rules of progression are larger curves carry a higher risk of progression than smaller curves, and thoracic and double primary curves carry a higher risk of progression than single lumbar or thoracolumbar curves. In addition, patients not having yet reached skeletal maturity Escoliosis definicion yahoo dating a higher likelihood of progression i. This is seen to be due to rapid growth spurts occurring at puberty when spinal development is most relenting to genetic and environmental influences.
Incidence of idiopathic scoliosis IS stops after puberty when skeletal maturity is reached, however, further curvature may proceed Escoliosis definicion yahoo dating late adulthood due to vertebral osteoporosis and weakened musculature. The cost of scoliosis involves both monetary losses and lifestyle limitations that increase with severity. Respiratory deficiencies may also arise from
Escoliosis definicion yahoo dating deformities and cause abnormal breathing. Since scoliosis was discovered by Hippocratesphysicians and orthopedic surgeons have sought to find a cure for the condition.
In the midth century, modern medicine and treatment made decreasing the progression of scoliosis within patients and alleviating the pain they experienced possible. This was the result of the progression of scoliosis screenings and treatment. New ways were developed to treat scoliosis because the condition was increasingly understood among medical professionals and orthopedic surgeons.
These treatments such as bracing and rod insertion into the spine were made possible at the turn of the 20th century. During this time, many schools subjected their students to physical examinations and posture tests. Students were believed to suffer from negative effects such as poor posture due to hunching over desks for hours in the classroom.
Although these screenings were not intended to detect spinal curvature, physicians diagnosed many students with scoliosis. Scoliosis was considered a disease-based condition during the midth century caused by tuberculosis or poliomyelitis.
These diseases responsible for causing spinal deformities were successfully managed throughout the s due to the distribution of vaccines and antibiotics. Despite the successful management of diseases causing spinal deformity, many patients
Escoliosis definicion yahoo dating from scoliosis with no known cause. The unknown cause Escoliosis definicion yahoo dating eventually determined to be idiopathic scoliosis. Idiopathic scoliosis, also known as the "cancer of orthopedic surgery", was determined to be dangerous because there was no current treatment.
As a result, schools made it mandatory for students to have screenings for scoliosis. Early on, set symptoms could be recognized among the students being tested from ages five to eighteen, but subsequent studies never confirmed them for this age-range. To begin the screenings, children would have their shoulder height, leg length and spinal curvature measurements taken while partially clothed. This was followed with the forward-bend test and bodily comparisons to wall charts that were printed reproductions of the ideal Escoliosis definicion yahoo dating posture.
Unfortunately, these screenings were not always accurate and many students were misdiagnosed because poor posture could often be mistaken for scoliosis. One of the first treatments designed was the Milwaukee bracea rigid contraption of metal rods attached to a plastic or leather girdle, designed to straighten the spine. As a result of the constant pressure the brace inflicted on a patients' spine, it was particularly painful and inconvenient to wear due to physical limits it imposed. Wearing the brace was known to cause jaw pain, skin irritation, muscle pain and low self-esteem among patients.