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Did you ever wonder what the doctor was looking for when checking your back during your annual exam?. 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? - PowerPoint PPT Presentation
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Questions to PonderWhat 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?
byTosha S. Rhea
OverviewWhat is ScoliosisPrevalence of ScoliosisAdolescent Idiopathic
Scoliosis (AIS)Pedigree ChartSymptoms of AISAIS TestingAIS Treatment
ObservationBracingSurgery
Concluding Thoughts
What is Scoliosis?
An abnormal lateral curve to the vertebral column greater than 10°
Many different forms of 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°
Prevalence of Curvature/ScoliosisCurves 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
Adolescent Idiopathic Scoliosis (AIS)
Side-to-side curveGreater than 10°Twisting of the
spinal columnSpine resembles a
“C” or “S”
Patients are between 10 and 18 years
Curve gets larger during rapid growth
Otherwise, patients are healthy
No known cause30% have some
family historyGenetic connection
Pedigree Chart with Multiple Family Members affected with AIS
Closed symbols represent affected
individuals Squares - Males Circles - Females
Suggests a dominant mode of
inheritance
Symptoms of Scoliosis
Waist may appear uneven or hips elevated
One shoulder may appear higher
One side of the rib cage
may appear higher
One leg may appear shorter than the other
The body may tilt to one side
AIS TestingAdam’s Forward
BendX-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.
AISTreatment
Observation
Bracing
Surgery
ObservationConsider patient’s 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)
BracingUsed with curves between 25° and 40°
during the growth phase
Designed to each patient’s shape
Prevents curve progression
Worn under clothes
Worn all day or just at night
Worn until growth of the spine has stopped
Surgery Treatmentwith Spinal Fusion
Harrington Method Contrel-Dubousset Instrument
Fusion with one rod hooked to the spine
Obsolete “flatback”Increase wear and tearEarly onset of arthritisDegeneration of discsMuscle stiffnessReliance of painkillersFurther surgery requiredDisability
Fusion with a combination of two rods, screws, hooks, and wires
ModernLow rate of failure5-7 Day hospital stay3-4 Weeks out of school6 Month recovery timeFor more information go to
Scoliosis Research Society (SRS)
Concluding ThoughtsScoliosis 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.
Resourceswww.srs.orgwww.ejbjs.orgwww.journals.lww.com/corr/Abstract/
2000/03000/Idiopathic_Scoliosiswww.en.wikipedia.org/wiki/Scoliosis
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