GET THE FACTS ABOUT SCOLIOSIS

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GET THE FACTS ABOUT SCOLIOSIS
I.M. Doctor, M.D. My Office My City, State
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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.
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Get the Facts About Scoliosis

• Orthopaedics and the Bone and Joint Decade
• Scoliosis

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What is an orthopaedic surgeon?

• MD who specializes in treatment and health
  maintenance of musculoskeletal system (bones,
  joints, ligaments, muscles, tendons, cartilage
  and spine)

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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

• College
• Medical School
• Internship
• Orthopaedic Residency
• Fellowship (optional)
• 2 Years Practice
• TOTAL

• 4
• 4
• 1
• 4
• (1)
• 2
• 16 years!

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What do orthopaedic surgeons do?

• Diagnose
• Treat
• Medication
• Physical Therapy
• Exercise
• Brace
• Surgery
• Prevent

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Improving Musculoskeletal Care in America (IMCA)

• 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

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Get the Facts About Scoliosis
Your Orthopaedic Surgeon Getting You Back In The
Game
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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

• Abnormally shaped vertebrae at birth (congenital
  scoliosis)
• Syndromes or neurological disorders
• Unknown reasons

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Juvenile Scoliosis

• 20 of curves of gt20 degrees are due to
  underlying medical cause
• In many cases, cause is unknown
• This group accounts for 10-15 of childrens
  cases with unknown causes

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Adult Scoliosis

• 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

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Adolescent Scoliosis

• Occurs after age 10, before growth stops
• Often has no known cause (idiopathic)
• Most common type

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What causes scoliosis?

• Cause is usually unknown
• May be the result of birth defects and other
  medical conditions
• Sometimes runs in families

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What causes scoliosis?

• Scoliosis is NOT caused by
• Physical activity
• Carrying heavy things
• Bad posture
• Sleep position
• Lack of calcium

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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

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Diagnosing Scoliosis

• X-rays confirm physicians diagnosis
• CT scan or MRI may be recommended to make things
  clearer

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Treating Scoliosis

• Orthopaedic surgeons take care of muscle and bone
  problems
• An orthopaedic surgeon with special training in
  childrens spine problems will best be able to
  treat scoliosis

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Treating Scoliosis

• Orthopaedics
• Straightening the child

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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

• Observation
• Back brace
• Surgery

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Treating Scoliosis Observation

• Curves of lt20 degrees in growing children
• Curves of lt40 degrees in older patients

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Treating Scoliosis Observation

• Ongoing x-rays are taken to measure the curve and
  determine whether it is changing

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Treating Scoliosis Bracing

• Does not correct curve only prevents worsening
• For patients with 20-40 degree curves

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Treating Scoliosis Bracing

• Selected for specific patient and condition
• Milwaukee brace (Cervico-Thoraco-Lumbo-Sacral-Orth
  osis)
• Boston brace (Thoraco-Lumbo-Sacral-Orthosis or
  TLSO)
• Charleston bending brace

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Treating Scoliosis Bracing

• Must be worn for certain number of hours every
  day
• ALWAYS follow orthopaedic surgeons 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

• May be recommended for children with curve of gt45
  degrees
• If patient is done growing, may be recommended if
  curve is gt50 degrees

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Treating Scoliosis Surgery

• Implants and bone grafts straighten and fuse the
  spine
• Surgery is the only treatment that will
  straighten the spine

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Treating Scoliosis Surgery

• Potential risks include
• Nerve/spinal cord injury
• Healing problems
• Hardware problems

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Treating Scoliosis Surgery

• Walk without brace 2-3 days
• Discharge from hospital lt7 days
• Return to sports 6-9 months

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Living With Scoliosis Nutrition

• Eat a healthy diet, with 1,000 i.u. of vitamin D
  and 1,300 mg of calcium
• Eat calcium-rich foods

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Living With Scoliosis Nutrition

• Maintain a healthy body weight
• Absolutely NO SMOKING

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Living With Scoliosis Exercise

• Can help maintain strength and flexibility
• Can help minimize discomfort and loss of function

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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

• Consult with your orthopaedic surgeon before
  beginning any exercise program

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Living With Scoliosis

• Curving often slows or stops in adulthood
• Most normal activities are safe
• Pregnancy and childbirth usually safe
• Follow up with orthopaedic surgeon

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Living With Scoliosis

• Every patient and every case is different
• Treatment is customized to your needs
• Ask question, stay informed
• Partner with your orthopaedic surgeon

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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
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What are your questions and concerns?
Get the Facts about Scoliosis
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Get the Facts about Scoliosis

• Thank you for participating today
• Remember, your orthopaedic surgeon can help get
  you back in the game