Pediatric and Adolescent Idiopathic Scoliosis

Scoliosis is a lateral spine deviation of more than ten degrees; it is most common during adolescence, affecting females to males in a 10:1 ratio. The cause is still unclear in 80 percent of affected persons. However, it can sometimes be in people with cerebral palsy or neuromuscular diseases.

The patient is typically asymptomatic. However, it can occasionally lead to significant issues. For instance, the chest cavity will become smaller if the spine is deviated by more than 60 degrees impacting the full expansion of the lungs with shortness of breath or breathing difficulties. Deviation of greater than 90 degrees increases the risk of cardio-respiratory failure.

A spinal surgeon will monitor your child's condition by serially examining the spine X-rays to see if scoliosis worsens. If it is, tailor a back brace to prevent worsening scoliosis. However, if, despite the support of a back brace, the scoliosis progress, surgery to arrest the progression and prevent future clinical sequelae is appropriate.

Symptoms

Asymmetrical shoulders
One shoulder blade is more convex than the other
The waist or hips are uneven;
One side of the back is more convex than the other when bending forward,

When should you see a doctor?

If any of the above-mentioned physical abnormalities are present, patients should see a physician for diagnostic confirmation and receive treatment.

Cause

The actual etiology of the illness is still unknown. However, it may be genetically linked because the condition can pass on from generation to generation. Specific disorders can cause this syndrome, such as:

Neuromuscular diseases such as cerebral palsy or muscular dystrophy
Congenital abnormal spine development.
As a result, the spine is asymmetrical.
Chest surgery in infancy
Spinal injury or infection
Spinal cord disorders

Complications

Breathing difficulties – Scoliosis of more than 60 degrees will decrease chest cavity volume and compromise full lung expansion
Chronic back pain – For those who were symptomatic of scoliosis since childhood, if untreated, it will lead to chronic pain when they grow up.
Self-consciousness about body image – Increasing scoliosis accentuates physical deformities such as unbalanced hips and shoulders, protruding ribs, and lateral deviation of trunk and waist.
Spinal injury or infection
Spinal cord disorders

Diagnosis

The doctor will take a thorough medical history. During the physical examination, the patient will stand with his front side facing the wall and bend forward with his hands hanging freely to examine for protrusion of the shoulder blades and ribs on both sides. The doctor will also search for neuromuscular abnormalities and abnormal reflexes through a neurological examination.

X-ray examinations

Spine X-rays can confirm the diagnosis of scoliosis and reveal its severity. Furthermore, if scoliosis is present, your doctor may do further tests using magnetic resonance imaging (MRI) to find the cause.

Treatment

The severity of the condition will determine the treatment approaches. When a patient has mild scoliosis, there is typically no need for therapy. Follow-ups are necessary until it is sure that there is no further progression. If there is progression, the doctor may suggest the patient wear a back brace. However, if the scoliosis is likely to contribute to future disability, your doctor may recommend surgery to treat and stop further scoliosis before future complications develop.

Treatment parameters to consider:

Age of bone growth – If the spine has stopped growing, the possibility of further scoliosis is less
Degree of bone deviation
Gender - Girls are more likely than boys to have severe scoliosis.

Using a back brace

If a patient's bones are still growing and the scoliosis is moderate, the patient should wear a back brace. The brace is not curative, but it can help keep symptoms from worsening. Most back braces are made of plastic and are malleable to conform to the body contour. Moreover, it is not visible under your dresses. The gadget, which wraps around the underarms, ribs, lower back, and hips, must be worn for 20-23 hours daily. Children who wear back braces can engage in daily activities, including sports. The usage of the back support will end when they are no longer growing. Depending on the individual, girls often finish growing around the age of 14 and boys at the age of 16.

Surgery

The goals of surgery are to stop further scoliosis while restoring the spine to more normal alignment and anatomy. Currently, the following surgical procedures are available to treat this condition:

Scoliosis surgery with a specialized metal rod device that lengthens - if the scoliosis is severe in childhood, the spinal surgeon will implant the metal rod oriented along the spinal axis. The treatment goal is to coax the vertebrae to grow along the slat of the metal bar, allowing scoliosis to be straightened and corrected as the spine grows.
Corrective Scoliosis Surgery with spinal fusion - After the completion of corrective scoliosis surgery, the spine surgeon will fuse the adjacent vertebrae to keep the spine in the corrected positions and prevent deviation following the surgery.
Corrective Scoliosis Surgery without spinal fusion - Making small incisions on the side of the body for screw placements, a flexible, high-strength cable is then tethered to the screws to draw and return the crooked spine to a more normal position. This procedure ensures that the spinal joint retains its functional capacity following surgery.

Home remedies and Lifestyle Changes

The cause of scoliosis is not yet known. No activity is known to provide a cure for scoliosis. Patients can go about their daily lives, including exercise.

Coping with and assisting people with scoliosis

Adolescent scoliosis patients can be hard to manage. At that age, they usually have to cope with both physical and emotional changes of puberty. Scoliosis will add to the lack of confidence and fear of the abnormalities. In such cases, the patients should join group therapy to help them come to terms with the disease; and accept the use of a back brace or surgery. Children should be encouraged to speak to their peers or seek other help.

Preparation for a doctor's visit

Many schools have scoliosis screening processes in place. If found, you should make a doctor appointment for diagnostic confirmation.

Before your appointment

Make a list of the symptoms that the youngster is experiencing.
Make a list of the child's previous medical illnesses.
Make a list of medical problems that run in your family.
Make a list of questions to ask your doctor.

What to Expect When Visiting a Doctor

Following are some crucial questions your doctor may ask you.

When did the parents first detect the anomaly?
Is the patient in pain due to the condition?
Is the patient's breathing affected by scoliosis?
Is there someone else in your family who has scoliosis?
Has the patient's scoliosis worsened in the last six months?
The age when a patient had her first menstrual cycle (can predict more scoliosis in the future)