Diagnostic process of idiopathic scoliosis

  There are many patients who consult the Internet about scoliosis, and most of them have idiopathic scoliosis. Here I will talk about the general principles of idiopathic scoliosis treatment, so that patients and parents can do their own mental numbers.  1, first to clarify whether idiopathic scoliosis. First, a full spine frontal and lateral x-ray and left and right Bending (also called full spine hyperextension and hyperflexion lateral radiographs) + pelvic plain radiographs are taken to measure the scoliosis angle, clarify the type of scoliosis and Risser’s sign, and evaluate the scoliosis flexibility. A full spine MRI was done to rule out neurogenic scoliosis.  2. Develop a treatment plan based on the above imaging data: (1), patients with scoliosis less than 25 degrees – observation and follow-up, regular follow-up for 3-6 months, no follow-up after 18 years of age.  (2), patients with 25 degrees – 45 degrees – brace treatment. Milwaukee brace is used for the parietal spine above T7, and Boston brace is used for those below T7. The results of foreign studies require the brace to be worn for more than 16 hours, while domestic general requirements are 23 hours, leaving one hour for activity training such as bathing, gymnastics and breathing exercises. The brace treatment is reviewed once every six months. When the brace is removed 24 hours after the review, a full spine ortho-lateral radiograph is taken. When the brace is discontinued: boys are generally 17 years old (developmental maturity) and girls are generally 15 years old (2 years after menstruation). If the rate of scoliosis development exceeds 5 degrees during the brace treatment, the brace treatment should be considered ineffective.  (3), Patients with 45 degrees or more – surgical treatment. If there is a main curvature is thoracic curvature, accompanied by obvious razorback, trunk tilt, and vertebral rotation, it can be relaxed to 40 degrees. If the main curvature is lumbar curvature with severe spinal rotation, it can even be relaxed to 35 degrees.  3, conservative treatment of patients should perform gymnastic training: (1), single-arm external vibration: body upright, feet open and shoulder width, the ipsilateral hand top of the most convex place, the opposite side of the upper arm straight empty hand force to the convex side of the body to the limit of vibration, force down to the inner limit of the front of the body, do 40 times. 4 times a day. (In fact, it is a childhood reading radio gymnastics in a movement).  (2), bar suspension swing: facing the bar, hands straight arm climbing dangling body, and then slowly swing the waist and legs to the left or right, while moving along with the hands climbing the bar, so that the curved spine gradually straighten, repeat the exercise, without counting the number of times.