Transcript Get the “spin” on scoliosis - Legacy of Heroes

GET THE FACTS ABOUT SCOLIOSIS
I.M. Doctor, M.D.
My Office
My City, State
The information in this presentation was provided to the
presenter by the American Academy of Orthopaedic
Surgeons and may be modified.
Endorsement of this presentation by the AAOS is not implied
or inferred.
Thank you to members of the
Pediatric Orthopaedic Society of North America and the
Scoliosis Research Society
for contributions to the
content of this presentation.
Get the Facts About Scoliosis
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Orthopaedics and the Bone and Joint Decade
Scoliosis
What is an orthopaedic surgeon?
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MD who specializes in treatment and health
maintenance of musculoskeletal system (bones,
joints, ligaments, muscles, tendons, cartilage
and spine)
What is an orthopaedic surgeon?
The expert in treating the musculoskeletal
system
 The expert in maintaining musculoskeletal
health
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Educating an Orthopaedic Surgeon
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College
Medical School
Internship
Orthopaedic Residency
Fellowship (optional)
2 Years Practice
TOTAL
4
4
1
4
(1)
2
16 years!
What do orthopaedic surgeons do?
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Diagnose
Treat
Medication
 Physical Therapy
 Exercise
 Brace
 Surgery
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Prevent
Improving Musculoskeletal Care in America (IMCA)
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Part of AAOS commitment to Bone and Joint Decade
Resource for doctors and clinicians
Focus on conditions with greatest burden/cost to
society
Resource for health care policy makers
Get the Facts About Scoliosis
Your Orthopaedic Surgeon
Getting You Back In The Game
What is scoliosis?
Side-to-side curve of
spine
 Can cause misalignment
of shoulders or hips
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Who is affected?
Infant scoliosis: under 3
 Juvenile scoliosis: age 3-10
 Adolescent scoliosis: 10+
 Adult
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Infant Scoliosis
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Abnormally shaped vertebrae at birth (congenital
scoliosis)
Syndromes or neurological disorders
Unknown reasons
Juvenile Scoliosis
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20% of curves of >20 degrees are due to
underlying medical cause
In many cases, cause is unknown
This group accounts for 10-15% of children’s cases
with unknown causes
Adult Scoliosis
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May be the result of aging or medical problem
May have been present since childhood
Often diagnosed when patient feels pain or loss of
function
Adolescent Scoliosis
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Occurs after age 10, before growth stops
Often has no known cause (idiopathic)
Most common type
What causes scoliosis?
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Cause is usually unknown
May be the result of birth defects
and other medical conditions
Sometimes runs in families
What causes scoliosis?
Scoliosis is NOT caused by:
 Physical activity
 Carrying heavy things
 Bad posture
 Sleep position
 Lack of calcium
Who is affected?
Curves occur equally in
boys and girls
 Girls more often require
treatment
 Racial/ethnic groups
equally affected
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Diagnosing Scoliosis
Visual screenings:
Visual check by
school nurse
More complete
exam by physician
Diagnosing Scoliosis
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X-rays confirm physician’s
diagnosis
CT scan or MRI may be
recommended to make
things clearer
Treating Scoliosis
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Orthopaedic surgeons take care of muscle
and bone problems
An orthopaedic surgeon with special training
in children’s spine problems will best be able
to treat scoliosis
Treating Scoliosis
Orthopaedics =
“Straightening the child”
Treating Scoliosis
Complementary practices:
Can help patients feel better
overall
 Can help strength and
flexibility
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Treating Scoliosis
Complementary practices:
Should not replace traditional
medical care
 Beware of practitioners offering
“cures”
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Treating Scoliosis
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Observation
Back brace
Surgery
Treating Scoliosis: Observation
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Curves of <20 degrees in
growing children
Curves of <40 degrees in
older patients
Treating Scoliosis: Observation
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Ongoing x-rays are
taken to measure the
curve and determine
whether it is changing
Treating Scoliosis: Bracing
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Does not correct curve
—only prevents
worsening
For patients with 20-40
degree curves
Treating Scoliosis: Bracing
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Selected for specific patient
and condition
 Milwaukee
brace (CervicoThoraco-Lumbo-Sacral-Orthosis)
 Boston brace (Thoraco-LumboSacral-Orthosis or TLSO)
 Charleston bending brace
Treating Scoliosis: Bracing
Must be worn for
certain number of hours
every day
 ALWAYS follow
orthopaedic surgeon’s
instructions
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Treating Scoliosis: Bracing
“Time off” from brace can
be used for sports or
similar activities
 Brace should be worn
every day until child stops
growing
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Treating Scoliosis: Surgery
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May be recommended
for children with curve
of >45 degrees
If patient is done
growing, may be
recommended if curve
is >50 degrees
Treating Scoliosis: Surgery
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Implants and bone grafts
straighten and fuse the spine
Surgery is the only treatment
that will straighten the spine
Treating Scoliosis: Surgery
Potential risks include:
 Nerve/spinal
cord injury
 Healing problems
 Hardware problems
Treating Scoliosis: Surgery
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Walk without brace:
2-3 days
Discharge from hospital: <7
days
Return to sports:
6-9 months
Living With Scoliosis: Nutrition
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Eat a healthy diet, with
1,000 i.u. of vitamin D
and 1,300 mg of
calcium
Eat calcium-rich foods
Living With Scoliosis: Nutrition
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Maintain a healthy body weight
Absolutely NO SMOKING
Living With Scoliosis: Exercise
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Can help maintain strength and
flexibility
Can help minimize discomfort
and loss of function
Living With Scoliosis: Exercise
Aerobic sports
recommended
 Focus on flexibility
and core strength
 High-impact sports
may be restricted
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Living With Scoliosis: Exercise
Exercise cannot correct
scoliosis
 Avoid any practitioner
who makes such claims
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Living With Scoliosis: Exercise
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Consult with your
orthopaedic
surgeon before
beginning any
exercise program
Living With Scoliosis
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Curving often slows or stops in adulthood
Most normal activities are safe
Pregnancy and childbirth usually safe
Follow up with orthopaedic
surgeon
Living With Scoliosis
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Every patient and every
case is different
Treatment is customized to
your needs
Ask question, stay informed
Partner with your
orthopaedic surgeon
Resources
American Academy of Orthopaedic Surgeons
6300 North River Road
Rosemont, IL 60018
orthoinfo.org
Pediatric Orthopaedic Society of North America
posna.org
Scoliosis Research Society
srs.org
Get the Facts about Scoliosis
What are your questions and concerns?
Get the Facts about Scoliosis
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Thank you for participating today
Remember, your orthopaedic surgeon can
help get you back in the game