Understanding Scoliosis

Summary

This informative video by Dr. John Shim explores scoliosis, highlighting its natural spinal curvature and the differences between normal spine alignment and abnormal curvature. It discusses the two main types: idiopathic scoliosis, common in children, and degenerative scoliosis in the elderly. The video details diagnostic methods, including the Cobb angle measurement, and emphasizes the importance of early treatment. Treatment options range from bracing for mild to moderate curves to surgical interventions for severe cases. Dr. Shim also addresses the potential complications and recent advancements in treatment methods, providing valuable insights for understanding and managing scoliosis.

Takeaways

• 😀 The spine has a natural 'S' curvature when viewed from the side, with 'C' shapes in the neck and lower back, and a reverse 'C' in the middle chest region.
• 😀 Scoliosis is characterized by an abnormal sideways curvature of the spine, which is straight when viewed from the back.
• 😀 A curvature exceeding 10 degrees in children under 10 or 20 degrees in older patients is considered scoliosis.
• 😀 Idiopathic scoliosis, accounting for 80% of childhood cases, has no specific known cause, while juvenile scoliosis can be progressive.
• 😀 Degenerative scoliosis results from natural disc degeneration and is most common in the elderly, affecting about 40% of the population.
• 😀 Common symptoms of degenerative scoliosis include back pain, difficulty standing upright, and sciatica, which is pain radiating down the legs.
• 😀 Children are screened for scoliosis during check-ups, focusing on shoulder blade asymmetry and hip height differences.
• 😀 The Cobb angle is used to measure the degree of spine curvature by assessing the angles of the vertebrae at the end of the curve.
• 😀 Mild curves (20 degrees or less) may not cause significant symptoms, while severe curves (50 degrees or more) can lead to complications.
• 😀 Treatment options for scoliosis include bracing for moderate curves and surgical intervention, such as spinal fusion, for more severe cases.

Q & A

What is the normal curvature of the spine?

The spine has a natural curvature shaped like an 'S' when viewed from the side, with the neck and lower back regions shaped like 'C' and the middle chest region having a 'reverse-C' shape.

How does scoliosis manifest in the spine?

Scoliosis is characterized by an abnormal sideways curve of the spine. When viewed from the back, a normal spine appears straight, while a spine with scoliosis shows a noticeable curve.

At what degree of curvature is scoliosis considered significant in children?

Scoliosis is considered significant if the curvature exceeds 10 degrees in children younger than 10 years or 20 degrees in patients older than 10 years.

What is the most common form of scoliosis and what does 'idiopathic' mean?

The most common form of scoliosis is idiopathic scoliosis, which means that there is no specific known cause for the curvature.

What are the potential consequences of untreated scoliosis?

Untreated scoliosis can lead to severe complications, including spinal instability, disc herniations, spondylolisthesis, sciatica, uneven gait, and nerve damage.

What screening methods are used to detect scoliosis in children?

During annual check-ups, doctors check for asymmetry between the shoulder blades, shoulder height, and hip height. Diagonal lines across the shoulders and waist may indicate scoliosis.

How is the Cobb angle measured?

The Cobb angle is measured by identifying the end vertebrae of the curve, drawing lines along their endplates, and measuring the angle formed by the intersection of these lines.

What is the recommended treatment for moderate scoliosis curves?

Bracing is recommended for patients with moderate curves between 20 and 40 degrees that are progressive, typically worn for 16 to 23 hours a day until growth is complete.

What surgical options are available for severe scoliosis?

For severe scoliosis, surgical intervention may be necessary, with spinal fusion being the most common procedure. Modern techniques also use pedicle screw systems to correct the curvature.

What advancements have been made in scoliosis surgery?

Recent advancements include GPS-guided robotic surgery and improved monitoring of the spinal cord and nerve roots, which have resulted in better surgical outcomes.