Adult Scoliosis Research Paper Example

Adult Scoliosis Research Paper Example Adult Scoliosis Paper Adult Scoliosis Paper Introduction All spines have curves, but the spine develops curves in the wrong direction sideways. It is natural for the spine to curve forward and backward to a certain degree; giving the spine an S-like shape. When a persons spine twists to develop an S-shaped side-to-side curve, then this condition is known as scoliosis. A 14th century woman who suffered from scoliosis, Limburgs Museum Venlo A scoliosis curve can occur in different areas of the spine. The abnormal curve can occur in the thoracic spine, the lumbar spine, or both areas at the same time. The curves can range from10 degrees to more than 100 degrees. The degree of curvature from the normal is a measure of the severity of scoliosis is. It helps the surgeon decide what treatment to be given. Curves less than 40 degrees will be treated without while curves above this amount might require a surgery. Diagnosis Scoliosis if suspected in an adult, appropriate treatment plan can be developed after a thorough diagnosis. History To make a proper diagnosis and rule out other possible conditions, history of patient is taken in the first step. Family History Scoliosis tends to have a genetic cause. The doctor want to know if anyone else in your family has scoliosis. Date of Onset – Time when first noticed the appearance of your spinal condition. Measured Curve Progression This is be measured by comparing new X-rays with old ones, measuring the rib hump, or changes in height. Presence or Absence of Pain If there is pain, doctor needs to know where and what brings on or induces the pain, and if there is any pain that radiates away from the spine, it usually comes from irritation of the nerves as they leave from the spine. Bowel or Bladder Dysfunction If you are having problems when you urinate or have a bowel movement it could signal the presence of serious nerve damage. Physical Exam A physical examination is performed. During the exam, the spine specialist will try get an understanding of the curve in your back and how it is affecting you. The provider will measure the size of the rib hump deformity and the flexibility you have bending in certain directions. Finally, your nerves will be tested by: checking your sensation, your reflexes, and the strength of your muscles. Additional Tests Usually, after the examination, X-rays will be ordered that allow the provider to see the structure of the spine and measure the curve. With scoliosis the following images may be taken: Front view, Lateral view and Lateral bend and Traction films Depending on the outcome of your history, physical examination and initial X-rays, other tests may be taken to look at specific aspects of the spine. The most common tests that are ordered are: the MRI scan to look at the nerves and spinal cord; the CAT scan to get a better picture of the vertebral bones; and special nerve tests to determine if any nerves are being irritated or pinched. Treatment for Adult Scoliosis Adult scoliosis has a variety of treatment options. The first choice of treatment for adult scoliosis is always going to be conservative. Spinal surgery will always be the last choice of treatment due to the risks involved. Conservative treatment that is commonly recommended includes: medications, exercise, and certain types of braces to support the spine. Physical Therapy Exercise and Physical therapy is an important part of treating adult scoliosis. A well-designed exercise program can also provide pain relief in many patients. A physical therapist will develop an appropriate exercise routine for your case. It is essential that you stick to the plan. Surgery Surgery for adult scoliosis carries relatively high risks. For this reason, surgery is only recommended when the risks are far outweighed by the expected benefits. Surgery will not be recommended for most cases of scoliosis, particularly in curves of less than 40 degrees. Surgery may be recommended in the following situations: * Pain The most common reason for surgery is pain relief for increasing, chronic discomfort. About 85 percent of adult scoliosis surgeries are done to relieve severe pain. * Progression of Curve Progression of the scoliosis deformity is another reason for considering surgery. If the curvature continues to worsen, and it gets beyond 40 to 45 degrees, surgery may be suggested. * Cosmetics In most cases of scoliosis, surgery will not be recommended simply for the sake of appearances. However, in some cases, the scoliosis causes physical deformity that is unbearable to the patient. Possible Complications/Problems with Surgery. There is a risk of complications with any surgery. When surgery is done near the spine and spinal cord these complications if they occur can be very serious. Complications could involve subsequent pain and impairment and the need for additional surgery. Doctor can evaluate your condition and inform you of the risks of any medical treatment he or she may recommend. In addition, the surgical treatment of adult scoliosis may result in two special complications: Flat-back Deformity The lumbar (lower) spine naturally has a C-shaped curve called lordosis. When the vertebrae in the lumbar spine are fused together, this lordosis curve may be lost, leaving the patient with a flat-back deformity. However, the loss of curve may not appear right after surgery. In fact, if the surgery it is done in a young person, the loss of lordosis may not appear until sometime between the ages of 30 to 50. Pseudoarthrosis The term pseudoarthrosis means false joint. A surgeon uses this term to describe either a fractured bone that has not healed or an attempted fusion that has not been successful. A pseudoarthrosis usually means that there is motion between the two bones that should be healed, or fused, together. When the vertebrae involved in a surgical fusion do not heal and fuse together, there is usually continued pain. The pain may increase over time. The spinal motion can also stress the metal hardware used to hold the fusion. The screws and rods may break, leading to an increase in pain. A pseudoarthrosis may require more surgery to try to get the bones to heal. Surgeons may add more bone graft, replace the metal hardware, or add an electrical stimulator to try to get the fusion to heal. Conclusion Journal of the American Medical Association (2003) published a 50-year follow-up study in the lifelong physical health, including cardiopulmonary and neurological functions and mental health of idiopathic scoliosis patients are comparable to those of the general population. 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 have a higher likelihood of progression. Females have a greater risk of progression. References 1. Adult Scoliosis | University of Maryland Medical centre http://umm. edu/programs/spine/health/guides/adult-scoliosis#ixzz2eJF7wEMP 2. Weiss HR, Scoliosis-related pain in adults: Treatment influences, European Journal of Physical Medicine and Rehabilitation 3/3 (1993): 91–94. 3. Scoliosis Research Society website Prepared and submitted to FRS Training Centre by Biju John Tutor: Anita Greene.