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CLICK HERE FOR OUR SCOLIOSIS SCREENING PROGRAM BROCHURE
"Scoliosis is the most deforming orthopedic problem confronting
children. It is a potentially progressive condition that affects
children during their active growth phase and essentially subsides
upon completion of spinal growth, leaving the child with a permanent
deformity. Early recognition and early treatment can be effective in
halting its progress and in many cases result in improvement." 1
"The most important factor in ensuring early diagnosis of scoliosis is
to routinely examine all growing children at regular periods during
growth. These periods should preferably be at six-month intervals
from early childhood until full maturity with greater attention
during the rapid growth phases that usually occur from ages 8
through 12. Early recognition and early treatment can be
effective in halting its progress and in many cases result in
improvement." 1 The goal of any screening program is to prevent severe spinal
deformity and its consequences.
"The effects of scoliosis in the child and its persistence into
adulthood are primarily cosmetic. However, pain can be significant
even after therapy and severe scoliosis can result in
cardiopulmonary complications that can decrease life span." 1
Scoliosis, a term used by Hipocrates, means abnormal curvature of
the spine. When a scoliosis develops the spine bends sideways and rotates
along its vertical axis.
When looking at someone from behind, the spine curves
either like a "C" or like an "S." The curve is named by the side of
convexity, ie. if the curve looks like an "S," the top curve would
be left and the bottom curve would be right. There are many theories
as to the cause of scoliosis, but the true causative factor of most scoliosis
curves remains unknown. The most common scoliosis is called adolescent idiopathic
scoliosis. The word idiopathic means cause unknown. It is 8-10 times more common in
girls than boys and accounts for 90% of the curves seen in clinical practice.
Scoliosis can be caused by congenital deformities, neuromuscular diseases and paralysis,
but these causes make up a small percentage of scoliotic curves.
A significant curve of more than 25 degrees is now estimated to be present in 1.4 per thousand of
the population, with approximately 2 percent of the adult population
demonstrating some degree of spinal curvature. According to the Scoliosis Research Society,
about 10% of the adolescent population has some degree of scoliosis. This means that about
1,000,000 children just in the United States have scoliosis. About on fourth of these children,
or 2%-3%, will require medical attention which may consist of observation for further
progression of the curve, bracing or surgery, depending upon the degree of the curvature
at the time of its detection. Some scoliosis may be so mild that treatment may never be necessary.
Early diagnosis depends on an awareness of its possibility with the
hope that early diagnosis will ultimately reveal early minimal
scoliosis and result in early referral for treatment."
The initial examination of the patient consists of observation from
the back, front and side in the standing and bent forward position.
A easy assessment can be made from the back as per the pictures above.
Have the person bend forward from the waist and
look for the "rib hump" caused by the bunching of the ribs together on
the side of the curve.
If a significant scoliotic curve is discovered, X-rays are taken of
the involved area of the spine from the front and side.
A measurement is taken to determine the severity of the curve.
Both the degree and rapidity of progression of the curve determine
the proper treatment of the patient.
A study in the January 1, 2004 journal Spine concluded that
capping of the iliac apophysis (Risser sign) is not a reliable
indicator of the end of spinal growth. The rib epiphysis and the
proximal humerus growth centers should be considered as well as lack
of standing height increases on two consecutive visits.
Contact us at 301-622-9000 for a proper and thorough scoliosis screening!
Maryland Law and Scoliosis Screening
"Code §7-405 requires each public school system in conjunction with the local health department
to provide scoliosis screening tests for all students at least once in grades 6 through 8.
Regulation 13A.05.05.07 Section A defines the age that school children must be screened and
designates responsibility for screening to local school systems and health departments.
Local health departments must conduct the screening in all nonpublic schools and fund the
screening in all schools."
Scoliosis Screening Requirements in Maryland
1 Scoliosis: Diagnosis and
Management
by Rene Cailliet, MD
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SCOLIOSIS