The prevalence of scoliosis among adolescents is high, approximately 0.1-1.33%. Scoliosis is defined as a lateral curvature of the spine in the coronal plane of more than 10°. However, in addition to lateral curvature of the spine in the coronal plane, scoliosis is a three-dimensional deformity of the spine in which there is also distortion of the spine and thoracic cross-section and abnormalities in the sagittal plane. There are many causes of scoliosis, including congenital, idiopathic, neuromuscular and functional scoliosis, with idiopathic scoliosis being the most common.
How to detect scoliosis in children
Early scoliosis causes cosmetic abnormalities that are not obvious and can be difficult to detect in time. Most children with scoliosis are long and thin and may have the following manifestations.
1. When bending forward in an upright position, the child’s back is not equally high on both sides;
2, the neckline and shoulders are not flat;
3, one side of the back abnormal bulge;
4, the girl’s double breast development asymmetric;
5.With folds on one side of the waist;
6.The hips on both sides are not equal in height;
7.The lower limbs on both sides are not equal in length.
If these abnormalities occur, parents need to be alert, it is best to go to the hospital orthopedics, rehabilitation medicine department.
What is the impact of scoliosis on children
Scoliosis often has both physical and psychological effects on the child. In addition to common deformities such as razorback, pelvic tilt, thoracic asymmetry, and unequal shoulders, scoliosis can also cause imbalance of forces in the spine and on both sides, resulting in low back pain and affecting the child’s height development; severe deformities can compress the spinal cord or nerves, causing paraplegia or spinal stenosis. In addition, scoliosis can also affect the normal development of the child’s thorax, compressing the heart and lungs, which can cause cardiopulmonary dysfunction. The deformity in appearance caused by scoliosis often causes many children to develop low self-esteem, shyness, depression, anxiety, fear, autism and other personalities, which seriously affects the healthy psychological development of children.
It is especially important to note that scoliosis is a progressive disease that gradually worsens as the child grows and develops, with scoliosis progressing in nearly two-thirds of skeletally immature patients, and its residual deformity lasting a lifetime. Therefore, children should be treated promptly and aggressively once scoliosis is detected.
Rehabilitation assessment of scoliosis
Scoliosis is a complex three-dimensional deformity, and each child has its own natural course, so it is especially important to assess the child for rehabilitation before proceeding with treatment. A rehabilitation evaluation for scoliosis includes a routine physical examination, spinal x-ray, pulmonary function tests, etc., as well as an assessment of psychological status. A comprehensive rehabilitation assessment helps the specialist understand the type, severity, and flexibility of scoliosis, determine the degree of curvature at different facets and the degree of rotation of the vertebrae, and clarify the risk of scoliosis progression so that an individualized treatment and rehabilitation plan can be developed.
Rehabilitation of scoliosis
Many parents are very nervous and even overwhelmed when they find out that their child has scoliosis, and often go to doctors everywhere and take their child to treatment when they hear that something works, with little success. So, what exactly is the treatment for scoliosis?
There are two types of treatment for scoliosis: rehabilitation and surgery, and the choice of method depends on the severity of the scoliosis and the possibility of further growth in the future.
The internationally respected treatment for early and mild scoliosis is rehabilitation. For congenital scoliosis and some specific types of scoliosis, early surgery should be performed if the primary or secondary curvature is aggravated, and the best time for surgery should not be delayed by concerns about the effect of surgery on height. Rehabilitation is also needed before and after surgical treatment to improve respiratory function and strengthen muscle strength so that surgery can achieve optimal results and reduce surgical complications.
The rehabilitation methods for scoliosis include exercise therapy, manipulative therapy, brace therapy and comprehensive therapy, which aim to reduce surgical treatment by controlling the progression of scoliosis.
Exercise therapy is one of the common and effective rehabilitation treatments for scoliosis and can help improve lateral deformity and rotation of the spine through proper prescription. There are a wide variety of exercise therapies, including three-dimensional exercise therapy, axial spinal weight loss training, lateral shift exercises, suspension exercises, quantitative trunk rotation strength training, trunk stability training, and individual functional training. Exercise therapy can enhance trunk muscle strength and spinal stability, reduce myofascial restrictions on the three planes of spinal activity, improve respiratory muscle control, increase lung capacity, enhance coordination, spinal proprioception and motor control, and establish new correct postural patterns in functional positions, thereby improving spinal deformity, reducing scoliosis progression, and delaying surgical treatment. The effectiveness of exercise therapy depends largely on the flexibility of the scoliosis and the patient’s compliance.
Bracing has been used for more than 50 years and is the most common method of treatment in conservative therapy. The goal of bracing is to guide the longitudinal growth of the spine until maturity and to control scoliosis from progressing. Wearing a brace and performing exercise training can increase corrective strength, activate muscles, improve respiratory function, and help patients psychologically.
Comprehensive rehabilitation of scoliosis is recognized by the International Society for Scoliosis Surgery and Rehabilitation. Comprehensive rehabilitation treatment, including exercise therapy and bracing, can effectively reduce the rate of surgery in scoliosis patients, and the development of a comprehensive rehabilitation program must be considered on an individual basis.
Adolescents are a critical stage of growth, and I believe we all would like our children to have a straight and fit body. If parents find their child suffering from this condition, they should actively visit the rehabilitation and orthopedic departments of the hospital and take the initiative to cooperate with the doctor for early and proper treatment to prevent the aggravation of deformity and disability.