June Is National Scoliosis Awareness Month

Each month I try to devote the Medical Update column to an awareness campaign or specific health observance for that month. June, is National Scoliosis Awareness Month.

In 2005, my then 13-year-old sister had surgery to have steel rods placed in her spine. She had been diagnosed with Scoliosis 4 years before. She had tried to wear a brace to correct the improper curvature of her spine. The brace did not work, in part because of her failure to wear the brace as indicated by our pediatrician. She saw a specialist, and because our mother worked at the hospital at the time, the doctor knew her and knew that the surgery was such that we couldn’t afford to have it done. This doctor donated his time, waived all his fees, and did my sister’s surgery for free. A major portion of the bill was also picked up by the hospital because of our insurance plan through Mother. I remember right after surgery, my sister spent a couple of days in the Intensive Care Unit (ICU) and was then transferred to the pediatric unit. Her recovery process was long, painful, and involved a lot of physical therapy.

Scoliosis, as defined by the Mayo Clinic, is “a sideways curvature of the spine that occurs most often during the growth spurt just before puberty.” For the most part, the cause of this abnormal curvature is unknown, though it can occur in conjunction with other conditions such as cerebral palsy and muscular dystrophy. My sister fit into the category of “we don’t know why she has it.” For most children, scoliosis is a benign condition and the degree of curvature is mild. For other children, (like my sister,) the curvature is more sever and needs medical intervention. The condition continues to worsen as they grow and can become very debilitating. It can cause a wide range of complications, including not being able to breathe adequately due to decreased space in the chest.

Signs and Symptoms
In some children with mild curvature, it is difficult to see outward signs. In others, you can readily see the changes. Some that you might see would include the following:

• Uneven shoulders
• One shoulder blade appearing more prominent than the other
• Uneven waist
• One hip higher than the other

As the curvature gets worse, the spine will often twist or rotate in addition to the side-to-side, s-shaped curvature. This can cause ribs on one side to stick out further than the other side. Severe scoliosis can also cause difficulty breathing and back pain.

Risk Factors
Though both males and females can develop Scoliosis, the condition is much more prominent in females. It occurs most often during the last growth spurt before puberty. Scoliosis may or may not have a genetic component as it seems to run in some families but not all who are diagnosed have a family history of the condition.

Complications
Complications from Scoliosis include the following:

• Lung and heart damage: when severe, the rib cage can press against the lungs and heart, causing damage to these organs as well as others in the chest cavity.
• Back problems: more likely to have chronic back pain as adults if they had Scoliosis as children
• Appearance: as the condition progresses, it can cause a change in appearance and affect body image

Testing and Diagnosis
If your pediatrician suspects your child is developing Scoliosis, one of the first tests they perform is very simple: they ask the child to stand up and then lean forward at the waist allowing the arms to hang loosely in front of them. This allows them to see if there is a noticeable shift of the shoulder blades or rib cage. Other testing that your doctor might suggest include MRI (magnetic resonance imaging), CT (computerized tomography) scan, and bone scans (injection of radioactive materials that allow for visualization of injured or healing bone tissue).

Treatment
For mild curvature, general treatment is close monitoring. More sever curvatures may require braces or surgical intervention to correct the problem. Some alternative treatments include chiropractic manipulation, stimulation of muscles with electrical currents, and biofeedback.

For more information about Scoliosis and raising awareness, visit the Scoliosis Research Society at www.srs.org and www.mayoclinic.org.
By: Rachel Clark, RN, BSN