| Scoliosis Treatment Perth |
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Scoliosis is the medical term for curvature of the spine. The curvature may be functional (correctable) or structural (fixed).Structural scoliosis occurs in approximately 2% of women and less than 1/2% of men. It usually starts in the early teens or pre-teens and may gradually progress as rapid growth occurs. Once rapid growth (puberty) is over then mild curves often do not change while severe curves nearly always progress.
There is a fine line between the term scoliosis and a very mild curve in a normal spine. Curves are measured in degrees. Persons with a curve of ten degrees or less are often thought to have just an asymmetry of the spine - but in children who end up with significant curves we have to consider that they started with a straight spine so even a ten degree curve can progress to a fifty degree curve and a significant deformity, if there is enough growing time remaining. Persons with curves measuring under thirty degrees entering adulthood are considered having a mild curve while those over 60 degrees are considered severe.
The treatment options depend on the severity and the age of the person. We can, of course, make up a long list of treatments; only a few have actually been shown to affect the outcome of scoliosis. In structural progressive scoliosis numerous studies have failed to show any benefit from exercise, manipulation, meditation or drugs. While exercise is beneficial to maintaining good muscle tone and a healthier heart and lungs, with severe scoliosis there is no evidence that it affects, one way or the other, the curve progression. It may help in reducing discomfort.
Option 1. Do nothing. The decision to do nothing may be a reasonable decision depending on the age of the person and the predicted outcome. If the person is a teen or pre-teen and the prediction is that this curve will worsen then doing nothing may not be appropriate. Increasing curves usually give an increase in the deformity. That is the chest twists throwing the shoulder blade off in back causing a rib hump and the chest in front rotates as well causing unevenness to the breasts. At the same time the hips at the waist become more uneven. So doing nothing in the teen years may be disastrous.
On the other hand, if the person has reached maturity ( physical at least!) then if the curve is mild, below forty degrees, it may not increase any more. So not doing anything may be okay.
A physiotherapist or chiropractor will be able to determine whether the sciolosis is structural al functional and advice and keep an eye on the scoliosis, using techniques such as manipulation, muscle release and strengthening exercises.
Option 2. Wear a brace. Bracing has been shown to be an effective method to prevent curves from getting worse. From a practical aspect though this treatment is reserved for children and adolescents in whom the prediction of a rapid increase in the curve needs to be thwarted. A brace worn 16 or more hours per day has been shown to be effective in preventing 90% or more of the curves from getting worse. Unfortunately, a brace worn 23 hours per day and worn properly does not guarantee that the curve will not continue to increase. Still, in curves that are mild i.e. between 20 and 35 degrees a brace may be quite effective.
In adults, the curve may progress slowly over the years, bracing is not a practical solution to prevent curves from increasing. Mild curves under 30 degrees do not usually progress; severe curves over 60 degrees usually progress and scoliosis between 30 and 60 degrees may or may not progress.
It must be remembered that a brace for a teenager is not an easy treatment. The brace is hot, hard, uncomfortable, ugly and while it normally can't be seen under the clothes definitely makes a teenager more self-conscious.
We tend to use a brace for 23 hours per day. Using it part time seems to create problems of when to put it on, when to take it off, and for how long; whereas if it becomes part of the routine it becomes a standard function. Additionally, logic supported by data shows that the more the brace is on the better the chance of maintaining correction. |
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| NOTE HOWEVER THAT A BRACE USUALLY DOES NOT CORRECT A CURVE. AT BEST IT WILL STOP IT FROM WORSENING. |
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Option 3. SURGERY: For those persons who already have a significant curve with a significant deformity surgery can reduce the curve and significantly reduce the deformity. Usually surgery is reserved for teen and pre-teens who already have a curve around 40 degrees or more. In our practice we tend to be more aggressive than many in doing surgery around 40 degrees while there are many excellent surgeons who defer to 45 or 50 degrees. In the adult age range the reasons for doing surgery are less well defined but include an increasing discomfort or pain in a curve that appears to have increased. For many women the deformity in the hip line and the increasing discomfort combine to make surgery a reasonable option. Many persons note the increasing deformity in the chest coupled with an increase in the rib hump. For those persons surgery can ( not always and certainly not guaranteed) reduce the deformity and the discomfort or pain.
Surgery however is a big deal and not to be undertaken lightly. We invariably use metal rods and screws to help straighten and hold the spine in the corrected position.
There are three major types of curves each with their own method of correction. However, what we do may not be what someone else would do. Surgeons base their procedures on many different factors including their experience with techniques and their outcomes.
The usual scoliosis curve is a thoracic curve ( i.e. at the level of the chest.) In these curves the procedure is a posterior spinal fusion. A fusion is a procedure where the individual bones are made solid each to the one above and below. Typically 10 or more segments are included. In order to first get as much correction of the curve, screws are attached to both sides of the back of the individual vertebra and then these are connected to two metal rods which have been pre-bent to the desired contour. The rod is then coerced into the head of each of the screws on each side so that there is a line of screws with a rod attached on each side of the curve. After the correction is done, little bits of bone are flaked off the back of the vertebra so that when healing occurs the flakes of bone cross and become solid. Some surgeons use extra bone obtained from the back of the pelvis. The metal rod hopefully holds the correction until it is solid approximately in one year.
Scoliosis of some degree is common, and many treatable. If the scoliosis cannot be corrected, physiotherapy, massage and chiropractic can help with the pain associated with scoliosis. |
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| For more information on scoliosis ring CBD Wellness Centre on 94868653 |
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