Q: What is scoliosis? A: Not everyone’s spine is straight. Scoliosis, as the name implies, is a curvature of the spine to the side. A normal person’s spine is straight from the front, because people are symmetrical from side to side, while a scoliosis patient’s spine is shaped like a letter “C” or “S” from the front. Q: What are the signs of scoliosis? A: Scoliosis is divided into scoliosis of the thoracic spine and scoliosis of the lumbar spine. In appearance, scoliosis of the thoracic spine can be manifested as unequal shoulders, bilateral asymmetry of the thorax, elevation of the scapula on one side and depression on the other. Lumbar scoliosis tends to manifest as fullness of the lumbar muscles on one side and emptiness on the other, and in severe cases of lumbar scoliosis there may also be unequal height of both shoulders. Scoliosis usually only affects the appearance and does not cause symptoms. Some patients think their back pain or back pain is caused by scoliosis, but in fact, back pain and scoliosis are not very related, and people with a non-curved spine often have this symptom. Low back pain is a common symptom, mostly due to muscle strain in the low back, and can usually be relieved by rest, massage and topical medication. Q: What is neuromuscular scoliosis? A: Neuromuscular scoliosis is a scoliosis caused by imbalance in muscle strength due to neurological and muscular disorders, especially asymmetry of the paraspinal muscles, the most common causes include post-polio, cerebral spastic paralysis, progressive muscle atrophy, etc. In these patients, because the muscle strength of the paraspinal muscles is weakened or lost, the patient often cannot sit steadily on his or her own and often needs to be supported by both hands next to a chair to sit steadily. Q: What are the dangers of scoliosis? A: Mild to moderate scoliosis does not affect internal organ function or other bodily functions. Only severe scoliosis, generally more than 60 degrees, can lead to a significant reduction in the space between the thoracic and abdominal cavities, resulting in cardiopulmonary and gastrointestinal stresses and corresponding dysfunction. Cardiopulmonary dysfunction is defined as a decrease in activity tolerance, such as panting and rapid heartbeat after walking for a short distance, or not being able to walk up two or three flights of stairs without taking a break to continue climbing. Reduced abdominal space can lead to decreased meal size and, in severe cases, can affect pregnancy. Q: Will scoliosis develop in adulthood? A: In adulthood, scoliosis over 40 degrees will also develop slowly, at an average rate of 1 degree per year. And at two ages will be significantly aggravated: one is 1-2 years after childbirth: scoliosis generally does not affect pregnancy and childbirth, but pregnancy and childbirth will make the scoliosis aggravated, because during pregnancy there will be ligamentous laxity, in addition to childbirth often hold the child resulting in a significant increase in spinal load, both factors often lead to significant progress in the degree of scoliosis; second is the age of 60 years after the osteoporosis period, osteoporosis can weaken the spine Strength, the original scoliosis under the action of gravity will become increasingly curved. Therefore, scoliosis patients in these two stages to consciously take measures, that is, after childbirth as little as possible to hold the child, after the age of 50 years old began to supplement calcium, after the age of 60 years old active calcium supplementation. Q: How is the degree of scoliosis measured? A: The degree of scoliosis can only be measured by taking an X-ray, which is usually a full-length X-ray of the spine taken in a standing position. After the film is taken, the reading is measured on the film. The degrees of thoracic curvature and lumbar curvature are measured separately, resulting in two degrees, one for the thoracic curvature and the other for the lumbar curvature, with the largest degree generally representing the severity of the condition. Q: Why do I get scoliosis? A: There are many causes of scoliosis, which can be broadly divided into congenital and acquired. Congenital refers to abnormal spinal development that occurs during the fetal stage before birth. The critical period of spinal development during the embryonic period is the fifth and sixth weeks of gestation, which is the time when the spinal column is segmented. If the fetus is exposed to drugs, viruses, physical and chemical factors during this period, it is prone to spinal developmental abnormalities. Acquired scoliosis tends to occur in adolescence, mostly after the age of 10. The causes of scoliosis in adolescents are not known, but in general it does not occur simply because of improper sitting and sleeping posture or the wrong way of carrying a school bag. Rather, there are more intrinsic causes, related to developmental abnormalities, neuromuscular imbalances, endocrine disorders, or impaired homeostatic regulation. There is no way to predict who will develop adolescent scoliosis and who will not. Q: Is scoliosis hereditary? A: Although some patients have a family history of scoliosis, the vast majority of patients do not pass scoliosis on to the next generation. Q: Is there a high incidence of scoliosis? A: The incidence of scoliosis is actually not low, with a prevalence of about 3%, or three out of every hundred people. What is this concept? That is, if you go out on the street and see two hundred people, there are six people with scoliosis among these two hundred people; or your child’s grade has three hundred people, if they all go to the film screening, can find almost ten scoliosis. But why do we all feel that we rarely see people with scoliosis? This is because although the prevalence of scoliosis is not low, as high as 3%, the vast majority of cases are mild. Scoliosis generally has to be more than 30 degrees to be visible when wearing tight clothing, and it generally has to be more than 40 degrees to be visible when wearing less tight clothing. The incidence of scoliosis above 40 degrees is much lower, about 3 in 1,000. Q: Is there a difference in the incidence of scoliosis between men and women? A: Congenital scoliosis is more common in boys, the ratio of men to women is about 4:1, while acquired scoliosis, that is, adolescent idiopathic scoliosis, girls are significantly more than boys, especially in patients with a curvature of more than 40 degrees, girls account for more than 90%. Q: Why is the incidence of girls so higher? A: The cause of its onset is not particularly clear, and we are still studying the problem, but it is true that there is such a phenomenon, a high incidence of girls, which shows that genes have a role in the development of idiopathic scoliosis. Q: What should parents do if they find that their child’s spine is not straight? A: Parents should be alert to the possibility of scoliosis if they find that their child has asymmetries in the shoulders or low back. You should take your child to the hospital to have an X-ray of the spine to determine if there is scoliosis. If scoliosis is present, a doctor should measure the angle. Q: If scoliosis is true, how should it be treated? A: Generally speaking, within 20 degrees of scoliosis only need to exercise and regular X-ray observation; 20-40 degrees of scoliosis need to exercise plus brace treatment; and if more than 40 degrees will need to consider surgery to correct. Q: I heard that some hospitals do massage traction and other conservative treatment, the efficacy is reliable? A: Scoliosis correction is not recommended to try yoga, massage, traction or herbal treatment. These are not based on science. Thousands of years ago, the Greek medical books can be seen in the traction bed orthopedic beds and other methods of treatment of scoliosis, but after thousands of years of verification, these simple treatment concepts have been proven ineffective and eliminated. In recent years, a large number of patients have also tried and proved ineffective, and currently all public tertiary hospitals in China do not do this treatment for this reason. Only some private small and medium-sized hospitals still do these treatments, but often for commercial purposes and with very limited results. Some small hospitals in Beijing, for example, do conservative treatments for scoliosis, which have been proven to be fraudulent. Some hospitals claim to have more than twenty patents, but they are also false propaganda. They even show foreign patients on the internet, but in fact they are just a few foreigners posing for pictures. I hope that patients and parents who have the ability to discern will not be fooled again. Q: Don’t you need brace treatment within 20 degrees? A: The correction effect of brace is proportional to the degree of scoliosis, the greater the degree, the greater the correction space of brace. If the degree of scoliosis is less than 20 degrees, the corrective effect of brace is limited and may restrict the child’s thoracic development, so it is better to wait until the degree exceeds 20 degrees before considering brace treatment. Q: If I don’t wear a brace but just take pictures regularly, how often should I take pictures? A: If the child is at the peak of development, that is, 10-13 years old, the film should be taken every 3 months, and after 13 years old, it can be taken every 6 months. Q: If the degree is 20-40 degrees, what is the brace treatment? A: Brace treatment must be tailored by a professional technician, do not simply buy a back brace, back brace is to correct habitual hunchback, it is useless for real scoliosis. The brace must be worn 20-22 hours a day, including sleep, only when bathing, sports can not wear. As the child grows in height, the brace needs to be replaced once a year. Girls should generally wear the brace for at least 2 years after menstruation. Q: What are the precautions for brace treatment? A: After the brace is done, we should take pictures to see the effect of brace correction, and we should take pictures after wearing it for 1 hour, the effect is the effect of brace correction at this time, and we can also feel whether the brace is suitable, if we feel uncomfortable, we can ask the technician to adjust it. In the past, some patients reflected that they wore the brace after having it done in other hospitals, and they did not take pictures to see the effect. This situation is very unwarranted, imagine if the brace does not work well or does not work at all, then wearing it for a year is not a waste of time, but makes the child suffer a lot. If you take a review every other year, you need to take off the brace 4 hours in advance so that it can truly reflect the current prescription. After taking off the brace, the prescription will bounce back, but the rebound is different for each person, so we need to see the real prescription after the rebound. Q: If the degree is 20-40 degrees, what does the exercise therapy include? A: Exercise mainly includes lateral bending, swallow flying and swimming. Lateral bending is suitable for “C” shaped (single bend) scoliosis, but not recommended if it is “S” shaped (“S” shaped refers to both thoracic bend and lumbar bend). Bend in the opposite direction of spinal curvature to counteract scoliosis, 50-100 per day, in 2-3 groups to complete. Swallow fly, exercise back muscles, increase soft tissue balance, 50-100 per day, completed in 2-3 groups. As for swimming, freestyle and breaststroke are available, 600-1000 meters per day. Some people also recommend hanging a bar, but it is more difficult to adhere to, the girl itself is small strength, can not do a few groups per day, the effect is difficult to guarantee.