1 Scoliosis Screening American Red Cross A Guide for School Nurses.
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Transcript of 1 Scoliosis Screening American Red Cross A Guide for School Nurses.
1
Scoliosis Screening
American Red Cross
A Guide for School Nurses
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Normal Spinal Curvature
There are 4 natural curves in the vertebral
column
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Linear Spinal Curvatures
Kyphosis Lordosis
Spine curves backward
in the chest area“Hunchback”
Spine curves forward at the waist“Swayback”
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Scoliosis
Sideways curvature of the spine
Spine turns on its axis like a corkscrew
Normal spine has a “l” appearance
Scoliosis produces an “S” or “C” appearance
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Degrees of CurvatureScoliosis is a lateral deviation of the normal vertical line of the spine which, when measured by an X-ray, is greater than 10 degrees.
MILD
MODERATE
SEVERE
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Causes of Scoliosis
Congenital Problem with the formation of vertebrae or
fused ribs during prenatal development Present at birth
Neuromuscular, Connective Tissue & Chromosomal Abnormalities
Caused by a neurological disorder of CNS or muscular weakness Cerebral palsy, Muscular dystrophy, Spina bifida, Paralysis Marfan’s Syndrome Down’s syndrome
Idiopathic Structural spinal curvature with no established cause Appears in a previously straight spine 80-85% of cases
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Diagnosis Physician Physical Exam Scoliometer measurements X Ray MRI
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Incidence
10% of population will have some degree of adolescent curvature
Affects approx 1 million children in the US3-5 out of every 1,000 cases are severe enough to require treatment25% will require medical attention to monitor for progression
YEARLY in the US (all forms)Affects 2-3% of the general population- 6 million
600,000 physician office visits30,000 children are treated with a brace 38,000 undergo spinal surgery
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Scoliosis Mythology Scoliosis can be caused by carrying heavy book bags, poor posture
or sleeping on a bad mattress
Sports favoring one side can cause scoliosis
Lower back pain in adolescents is an indicator for scoliosis
Scoliosis always progresses and requires some form of treatment
Scoliosis is similar to osteoporosis in it’s destruction of the bone
Scoliosis is usually painful
Minor leg inequality will lead to scoliosis
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Weighing In on the Back Pack
Issue
Children should carry no more than 10-15% of their body weight in a backpack.
Backpack should be worn on BOTH shoulders to evenly distribute the weight
Heaviest books should be closest to the back
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Scoliosis Facts Race, ethnic background & socioeconomics
do not appear to be factors
Tends to occur in families
Usually painless and without symptomsChild is generally unaware of curvature
Untreated scoliosis of greater than 30 degrees can lead to back pain in adults
60 % of curvatures in rapidly growing prepubertal children will progress
Increased risk for osteoporosis & gall bladder problems later in life
Poor nutrition may play a role
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Girls Vs Boys
Primary age of onset 10-15 years During the last major growth spurt of adolescence
Time of greatest risk: Girls: 6 months before & after onset of menstruation Boys: Time when their voices deepen risk
Mild scoliosis occurs equally between boys and girls (?)1 in 10 girls vs 1 in 25 boys
More serious curves (<30 degrees) are 8-10X greater in girls than in boys.
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Scoliosis Treatment**Treatment is not needed for the vast majority of cases**Observation:
•Minor curvatures (>20 degrees)•Skeleton is close to maturity•Exercises may help with surrounding muscular strength
Brace:•Around torso and hips•Helps hold spine in place while it grows•Can be removed for sports
Surgery:•Major curvatures (<45 degrees)•Rapid deterioration/progression•Generally spinal fusion**Generally physical therapy/exercises are not effective **