Scoliosis: Review of Diagnosis and Treatment: Janusz Popko, Michał Kwiatkowski, Monika Gałczyk
Scoliosis: Review of Diagnosis and Treatment: Janusz Popko, Michał Kwiatkowski, Monika Gałczyk
Scoliosis: Review of Diagnosis and Treatment: Janusz Popko, Michał Kwiatkowski, Monika Gałczyk
, 2018, 4, 31-35
E-mail: jpopko@umb.edu.pl
Abstract: Scoliosis is a spinal deformity consisting of lateral and rotation of the vertebrae. The causes of scoliosis
are varied and classified broadly as congenital, neuromuscular, idiopathic and spinal curvature cause by secondary
reasons. The essential components of diagnostics are patient history, physical examination, and radiographs. The
scoliometer is a very useful and safe tool in diagnostic and management of scoliosis. The treatment scoliosis
is based on age, curve management and risk of progression. It includes observation, orthotic magnitude and
surgical correction with fusion. These and other authors’ observations indicate that bracing is the most ef-
ficient non-surgical method of treatment for idiopathic scoliosis patients with 25◦ -45◦ curvature according to Cobb.
DOI: 10.19260/PJAS.2018.4.1.06
Figures
Introduction
c Copyright by the Lomza State University of Applied Sciences
Popko J. et al.: Scoliosis: Review of Diagnosis and Treatment Pol. J. Appl. Sci., 2018, 4, 31-35
Physical examination
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Pol. J. Appl. Sci., 2018, 4, 31-35 Popko J. et al.: Scoliosis: Review of Diagnosis and Treatment
Radiographs should be made on 36-inch film and ta- Correcting scoliosis utilizing surgical and non-surgical
ken standing. The Cobb angle is the most widely adopted methods should be three-dimensional and include the re-
technique to quantify the magnitude of spinal deformity [2]. storation of physiological thoracic kyphosis [15]. The main
Scoliosis is defined as a lateral spinal curvature with Cobb problem is the scoliosis progression in a patient. It has been
angle of 10◦ or more [2, 3]. proven that the best way to stop it is a back brace. Inva-
riably, the most important impact on treatment success is
Management principles consistency and conscientiousness in wearing an orthopedic
corset.
A diagnosis of scoliosis often causes apprehension. We In the assessment of the progression of the curvature
should reduce this anxiety because scoliosis is usually equ- on the basis of angles determined according to Cobb in
ated with treatment by braces or surgery. The indications the study group of 51 patients aged between 9 to 18 years
for treatment should be individualized; however, some ge- (84% females) of orthopedic brace wearers, we revealed a
neralizations can be made. In general, the treatment of sco- considerable curtailing of the process (Fig. 5). The main
liosis depends on the severity of the curve:
> 25◦ – the halting of scoliosis, rehabilitation treatment,
observe;
25 − 45◦ – brace treatment is indicated for immature pa-
tients where progression is defined as a documented
increase of 5 or more degrees;
> 45◦ – surgical treatment.
Our experience in treating scoliosis.
Surgical treatment
Fig 5. Bending exercises to the left and to the right leg correct scoliosis (own this point. A surgical procedure called “spinal fusion” will
Fig. 4: Bending exercises to the left and to the right leg correct scoliosis
drawing).
(own drawing). significantly straighten the curve and then fuse the verte-
brae together, so that they heal into a single, solid bone.
Brace treatment is indicated for immature patients Metal rods are typically used to hold the bones in a plane
with curves of 25◦ − 45◦ . Bracing usually slows or stops the until the fusion happens. The rods are attached to the spine
progression of most spinal curvatures [10–14]. by hooks screws, and for wires [21, 22].
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Popko J. et al.: Scoliosis: Review of Diagnosis and Treatment Pol. J. Appl. Sci., 2018, 4, 31-35
Literature
19
[1] Scoliosis Research Society Web site. Available at:
http://www.SRS.org/htm/glossary/medterms.htm.
Fig 9.8:X-ray
Fig. X-raypicture patient
picture withwith
patient shortshort
right leg (2,5cm)
right producing
leg (2,5cm) secondary
producing se-
Accessed December 2003. condary Scoliosis (own material).
[2] Xiong B., Sevastik J.A., Hedlund R., Sebastik B. Ra- Scoliosis (own material).
diographic changes at the coronal plane in early sco-
liosis. Spine, (19):159–164, 1994. [5] Hagglund G. CPUP – Swedish National Health Care
[3] Staheli L.T. Practice of Pediatric Orthopedics. LWW Quality Programme for prevention of hip dislocation
Press, 2nd edition, Philadelphia, 2006, pp. 159-164. and severe contractures in CP. Accessed 15 October
[4] Janicki J.A., Alman B. Scoliosis: Review of diagnosis 2007 from the website: www. cpup.se.
and treatment. Paediatr Child Heealth, (9):771–776, [6] Krawczyński A., Kotwicki T., Szulc A., Samborski W.
2007. Kliniczny i radiologiczny pomiar rotacji kręgów u cho-
34
Pol. J. Appl. Sci., 2018, 4, 31-35 Popko J. et al.: Scoliosis: Review of Diagnosis and Treatment
rych ze skoliozą idiopatyczną. Ortop Traumatol Reha- preferences and concerns in idiopathic adolescent sco-
bil, (8):602–607, 2006. liosis: a cross-sectional preoperative analysis. Spine,
[7] Bunnell W.P. An objective criterion for scoliosis scre- (25):2392–2399, 2000.
ening. J Bone Joint Surg, (66A):1381–1387, 1984. [20] Kwiatkowski M., Mnich K., Karpiński M., Domań-
[8] Karski T. Skoliozy tzw. idiopatyczne – etiologia, rozpo- ski K., Milewski R., Popko J. Ocena satysfakcji
znawanie zagrożeń, nowe leczenie rehabilitacyjne, pro- pacjentów z leczenia skoliozy idiopatycznej gorsetem
filaktyka. KGM, Lublin, 2002, pp. 1-211. piersiowo – lędźwiowym. Ortop Traumatol Rehabil,
[9] Karski T. Biomechanical etiology of the so-called idio- (17):111–119, 2015.
[21] Smoczyński A., Smoczyński M., Łuczkiewicz P., Pan-
pathic scoliosis (1995-2007). three groups and four
kowski R., Pobłocki K. Operacyjne leczenie bocz-
types in the new classification. J Now Physiother,
nego idiopatycznego skrzywienia kręgosłupa zmody-
14(2):69–79, 2013. doi:10,4172/2165-7025.S2-006.
fikowanym sposobem Harringtona podłukowymi pę-
[10] Rowe D.E., Bernstein S.M., Riddick M.F., Adler F.,
tlami drutu. Ann Acad Med Gedan, (37):103–110,
Emans J.B. Gardner-bonneau the efficacy of non- 2007.
operative treatments for idiopathic scoliosis. J Bone [22] Nowak R. A contemporary approach to surgical tre-
Joint Surg Am, (79):664–674, 1997. atment of scolioses. J Orthop Trauma Surg Rel Res,
[11] Karpiński M., Kamińska M. Skolioza idiopatyczna. Pe- (13):31–45, 2009.
diatria po dyplomie, (15):75–79, 2011. [23] Gorzkowicz B. Ocena jakości życia u pacjentów ze sko-
[12] Schiller J.R., Thakur N.A., Eberson C.P. Brace Mana- liozą idiopatyczną leczonych operacyjnie metodą Co-
gement in Adolescent Idiopathic Scoliosis. Clin Orthop trela – Dubousseta. Ann Acad Med Stetin, (2):25–31,
Relat Res, (468):670–678, 2010. 2011.
[13] Winiarski A., Zarzycki D., Koniarski A., Kalciński M.
Received: 2018
The natural history of idiopathic scoliosis. Ortop Trau- Accepted: 2018
matol Rehabil, (7):1–7, 2005.
[14] Negrini S., Donzelli S., Lusini M., Minnella S.,
Zain F. The effectiveness of combined bracing
and exercise in adolescent idiopathic scoliosis ba-
sed on SRS and SOSOSRT criteria: a prospective
study. BMC Musculoskelet Disord, (16):263, 2014.
http://www.biomedcentral.com/1471-2474/15/263.
[15] Kotwicki T., Szulc A., Dobosiewicz K., Rąpała K. Pa-
tomechanizm progresji skolioz idiopatycznych – zna-
czenie fizjologicznej kifozy piersiowej. Ortop Trauma-
tol Rehabil, (4):758–765, 2002.
[16] Rahman T., Bowen J.R., Takemitsu M., Scott C. The
association between brace compliance and outcome for
patients with idiopathic scoliosis. J Pediatr Orthop,
(25):420–422, 2005.
[17] Lenssinck M. L., Frijlink A.C., Berger M.Y.,
Bierman-Zeinstra S.M., Verkerk K., Verhagen A.P. Ef-
fect of bracing and other conservative interventions
in the treatment of idiopathic scoliosis in adolescents:
a systematic review of clinical trials. Phys Ther,
(85):1329–1339, 2005.
[18] Sapountzi-Krepia D.S., Valavanis J., Pantele-
akis G.P. et al. Perceptions of body image, happiness,
and satisfaction in adolescents wearing a Boston brace
for scoliosis treatment. J Adv Nurs, (35):683–690,
2001.
[19] Bridwell K.H., Shufflebarger H.L., Lenke L.G., Lowe
T.G., Betz R.R., Bassett G.S. Parents’ and patients’
35