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Curve of the spine scoliosis

Postby Tojalmaran В» 18.04.2020


Scoliosis is a medical condition in which a person's spine has a sideways curve. The cause of most cases is unknown, but it 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 the general population.

The many causes of scoliosis include neuromuscular problems and inherited diseases or conditions caused by the environment. At least one gene, CHD7 , has 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 dystrophy , spinal muscular atrophy , poliomyelitis , cerebral palsy , spinal cord trauma, and myotonia.

Scoliosis associated with known syndromes is often subclassified as "syndromic scoliosis". Another form of secondary scoliosis is degenerative scoliosis, also known as de novo 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. As bones start to become weaker and the ligaments and discs located in the spine become worn as a result of age-related changes, the spine begins to curve. The word 'de novo' is associated with this form of scoliosis as it means 'new', referring to the occurrence of the condition during later life.

People who initially present with scoliosis undergo physical examination to determine whether the deformity has an underlying cause and to exclude the possibility of the underlying condition more serious than simple scoliosis. The person's gait is assessed , with 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 the Adams forward bend test [33] 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 curve 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 angle , which is the angle between two lines, drawn perpendicular to the upper endplate of the uppermost vertebra involved 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 maturity , which together help predict the likelihood of progression. The conventional options for children and adolescents are: [39]. For adults, treatment usually focuses on relieving any pain: [40] [41].

Treatment for idiopathic scoliosis also depends upon the severity of the curvature, the spine's potential for further growth, and the risk that the curvature will progress. In all cases, early intervention offers the best results. A specific type of physical therapy 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 person with a device that covers the torso; in some cases, it extends to the neck. The most commonly used brace is a TLSO , such as a Boston brace , a 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 on the curves in the spine. The effectiveness of the brace depends on not only brace design and orthotist skill, but also people's 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 is 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 people with idiopathic scoliosis are comparable to those of the general population.

Scoliosis that interferes with normal systemic functions is "exceptional" [53] and "rare", and "untreated [scoliosis] people 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, people not having yet reached skeletal maturity have 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.

Although fewer cases are present today using Cobb angle analysis for diagnosis, scoliosis remains a prevailing condition, appearing in otherwise healthy children. Incidence of idiopathic scoliosis IS stops after puberty when skeletal maturity is reached, however, further curvature may proceed during late adulthood due to vertebral osteoporosis and weakened musculature. Ever since the condition was discovered by the Greek physician Hippocrates , the search for a cure has been sought.

Treatments such as bracing and the insertion of rods into the spine were employed during the s. In the midth century, new treatments and improved screening methods have been developed to reduce the progression of scoliosis in patients and alleviate the associated pain they suffer.

School children were during this period believed to suffer from poor posture as a result of working at their desks, and many were diagnosed with scoliosis. It was also considered to be caused by tuberculosis or poliomyelitis , diseases that were successfully managed using vaccines and antibiotics. The American orthopaedic surgeon Alfred Shands Jr. These patients were treated with questionable remedies. Measurements of shoulder height, leg length and spinal curvature were made, and the ability to bend forwards, along with body posture, was tested, but students were sometimes misdiagnosed because of their poor posture.

An early treatment was the Milwaukee brace , a rigid contraption of metal rods attached to a plastic or leather girdle, designed to straighten the spine. Because of the constant pressure applied to the spine, the brace was uncomfortable. It caused jaw and muscle pain, skin irritation, as well as low self-esteem. In , the American orthopaedic surgeon Paul Harrington introduced a metal spinal system of instrumentation that assisted with straightening the spine, as well as holding it rigid while fusion took place.

The now obsolete Harrington rod operated on a ratchet system , attached by hooks to the spine at the top and bottom of the curvature that when cranked would distract—or straighten—the curve. The Harrington rod obviates the need for prolonged casting, allowing patients greater mobility in the postoperative period and significantly reducing the quality of life burden of fusion surgery.

The Harrington rod was the precursor to most modern spinal instrumentation systems. A major shortcoming was that it failed to produce a posture wherein the skull would be in proper alignment with the pelvis, and it did not address rotational deformity. As the person aged, there would be increased wear and tear, early onset arthritis , disc degeneration, muscular stiffness, and acute pain. In the s, the gold standard for idiopathic scoliosis was a posterior approach using a single Harrington rod.

Post-operative recovery involved bed rest, casts, and braces. Poor results became apparent over time. In the s, an improved technique was developed using two rods and wires attached at each level of the spine. This segmented instrumentation system allowed patients to become mobile soon after surgery.

In the s, Cotrel-Dubousset instrumentation improved fixation and addressed sagittal imbalance and rotational defects unresolved by the Harrington rod system. This technique used multiple hooks with rods to give stronger fixation in three dimensions, usually eliminating the need for postoperative bracing. There are links between human spinal morphology, bipedality, and scoliosis which suggest an evolutionary basis for the condition.

Scoliosis has not been found in chimpanzees or gorillas. Some of the lumbar vertebrae in Pan are "captured", meaning that they are held fast between the ilium bones of the pelvis. Compared to humans, Old World monkeys have far larger erector spinae muscles , which are the muscles which hold the spine steady. While this may explicitly relate only to lumbar scoliosis, small imbalances in the lumbar spine could precipitate thoracic problems as well.

Scoliosis may be a byproduct of strong selection for bipedalism. For a bipedal stance, a highly mobile, elongated lower spine is very beneficial. Bipedality is hypothesized to have emerged for a variety of different reasons, many of which would have certainly conferred fitness advantages. It may increase viewing distance, which can be beneficial in hunting and foraging as well as protection from predators or other humans; it makes long-distance travel more efficient for foraging or hunting; and it facilitates terrestrial feeding from grasses, trees, and bushes.

Their fossils indicate that there may have been selected over time for a slight reduction in lumbar length to what we see today, favouring a spine that could efficiently support bipedality with a lower risk of scoliosis. The cost of scoliosis involves both monetary losses and lifestyle limitations that increase with severity.

Respiratory deficiencies may also arise from thoracic deformities and cause abnormal breathing. Genetic testing for AIS , which became available in and is still under investigation, attempts to gauge the likelihood of curve progression. From Wikipedia, the free encyclopedia.

Not to be confused with Sclerosis.

Lordosis, kyphosis, and scoliosis, time: 7:52
Posts: 221
Joined: 18.04.2020

Re: curve of the spine scoliosis

Postby Tojin В» 18.04.2020

It may reduce or eliminate pain in the near term, but symptoms can return later because of instability of the spine. Sometimes they also rotate twistlike a corkscrew. The bones are click here by discs, which act as shock absorbers and give the spine flexibility. September It's a treatment process called Priority Consult.

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Re: curve of the spine scoliosis

Postby JoJotaur В» 18.04.2020

If you think you have scoliosis, make an appointment with your health care provider. When pain does occur, a click nerve is typically the cause, not the scolliosis. Other conditions that might cause degeneration include:.

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Re: curve of the spine scoliosis

Postby Dur В» 18.04.2020

These patients were treated with questionable remedies. Madelung's deformity Copy Oligodactyly Polydactyly. Adolescent idiopathic scoliosis paste no clear causal agent, and is generally believed to be multifactorial. As long as http://mosaverha.tk/season/what-lies-beneath-house.php get the right treatment as kids or teens, their spine usually won't continue to curve after they're emoticons growing. In the midth and, new treatments and improved screening methods have been developed to reduce the progression of scoliosis in patients and alleviate the associated pain they suffer.

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Re: curve of the spine scoliosis

Postby Vikazahn В» 18.04.2020

Request an Appointment at Mayo Clinic. Retrieved 1 January Genetics Home Reference. Post-operative recovery involved bed rest, casts, and braces.

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Re: curve of the spine scoliosis

Postby Gacage В» 18.04.2020

Viewed from the side, the normal spine takes the form of an elongated S, the upper back bowing outward and the lower back curving slightly inward. This projection is typically used by spine surgeons, as it is see more surgeons see their patients when they are on the operating table scoliosks the prone position. Occasionally, teachers, friends and sports teammates are the first to notice a child's scoliosis.

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Re: curve of the spine scoliosis

Postby Zulurisar В» 18.04.2020

Archived from the continue reading on 2 January Archived from the original scoliosis 14 May Scoliosis has http://mosaverha.tk/movie/six-zeros.php described as a curve deformity, the progression of which depends on asymmetric forces otherwise known as the Hueter-Volkmann Curvs. The Neurophysiological Mechanisms in Scoliosis. Mild to moderate spinal spine is common in older adults, but it can also affect adults in their 50s and younger.

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