What is scoliosis 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, and progressive muscle atrophy. 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 cause 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 also develops 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 scoliosis worse, 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 The strength of the original scoliosis will be increasingly curved under the action of gravity. Therefore, scoliosis patients in these two stages should take conscious measures, that is, after the birth of children as little as possible to hold the child, after the age of 50 years old to start calcium supplementation, 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. The reading is measured on the film after it is taken. The degrees of thoracic 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. Scoliosis causes complex factors girls are particularly susceptible to Q: Why do you get scoliosis? A: There are many causes of scoliosis, which can be broadly divided into congenital and acquired. Congenital refers to the abnormal development of the spine before birth in the fetal stage. 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, then six of those two hundred people have scoliosis; or your child’s grade has three hundred people, if they all go to the film screening, you 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 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. Surgery is not considered for scoliosis within 40 degrees 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 asymmetry in the shoulders or low back. You should take your child to the hospital to take 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, scoliosis within 20 degrees only requires exercise and regular X-ray observation; scoliosis between 20 and 40 degrees requires exercise and brace treatment; and if it is more than 40 degrees, surgical correction should be considered. Q: If I don’t wear a brace but just take films regularly, how often should I take films? A: If the child is at the peak of development, that is, 10-13 years old, it 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 like? A: Brace treatment must be tailored by professional technicians, 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 the brace 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 for “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 sets to complete. Swallow fly, exercise back muscles and increase soft tissue balance, 50-100 per day, completed in 2-3 sets. As for swimming, freestyle and breaststroke are both available, 600-1000 meters per day.