Common spinal disorders
Common spinal disorders include idiopathic scoliosis, congenital spinal deformities, spinal tumors, spinal tuberculosis, spinal trauma (fractures, paraplegia), spinal inflammation, and spinal cord lesions. In addition to spinal surgery for single-segment lesions, scoliosis is typical in pediatric orthopedics, and scoliosis surgery is characteristic and challenging in the orthopedic discipline, and its surgical operation and internal fixation development have been very rapid in recent years. However, not all scoliosis requires surgery, and most scoliosis is manageable when detected and treated early.
Epidemiology of scoliosis
Scoliosis is a common and prevalent disease that affects young children in China. The incidence of scoliosis in primary and secondary school students in China is on a significant rise, but has not yet attracted much attention from families, schools and society. Idiopathic scoliosis is a disease of unknown origin but more frequent in adolescents, mostly in adolescents aged 12-16 years, with an incidence of about 20/100,000 and a male to female ratio of about 1:8. 20% of patients are congenital, that is, the fetus in the mother’s womb on the abnormal development; in addition, 80% of affected adolescents have unknown causes. Since the cause of the disease is unknown, it cannot be prevented and can only be detected early and corrected. If found late, the skeleton is fixed and can only be corrected through surgery, and about 1-2% of patients are clinically in the late stage. Nationwide, about 10,000 or more adolescents with scoliosis need surgery each year.
What are the dangers caused by scoliosis?
In general, scoliosis occurs mostly in the thoracolumbar segment, and pulmonary dysfunction may occur when its Cobb’s angle exceeds 60°. Most scoliosis above 90° has restrictive ventilation impairment due to its severe chest deformity, and cardiac dysfunction may also occur as scoliosis worsens. Some patients with scoliosis have significant trunk deviation and unequal shoulders, which seriously affects aesthetics. Idiopathic scoliosis is generally unlikely to cause paralysis, but may only cause paralysis if its Cobb’s angle exceeds 100°.
How is scoliosis confirmed?
The easiest initial check is to remove your shirt, unite your hands, and bend your head down 90 degrees to see if both shoulders are at the same level. children under 10 years of age are checked semi-annually, and children over 10 years of age are checked every 3 months, which will detect most children with early lesions and avoid the risk of late surgery.
Professional doctors examine patients with scoliosis, often starting with a medical history and physical examination. Some medical histories are helpful in making a diagnosis, such as scoliosis in patients with neurofibromatosis, which is a genetic disorder, and congenital scoliosis, which is often associated with congenital heart disease, urinary malformations, and neurological lesions. In addition to routine cosmetic examination, neurological examination is essential to observe the presence of sensory and motor deficits. Sensory separation usually indicates the possibility of spinal cord hollowing. Abdominal wall reflexes and pathological reflexes examination are items that every scoliosis patient should be examined, and neglecting these examinations can sometimes have disastrous consequences.
The purpose of frontal and lateral x-ray examination of the spine in the standing position is to
1. to obtain a preliminary understanding of the type of scoliosis, whether idiopathic, congenital or other types.
2, to measure the size of the scoliosis, the current common measurement is the Cobb’s angle, the larger the angle, the heavier the scoliosis.
3. assessing the balance and flexibility of the scoliosis.
4, an objective basis for comparison at follow-up.
How can scoliosis be prevented and treated?
There are three main approaches to the treatment of scoliosis, namely
1, regular follow-up visits.
2, brace treatment.
3, surgical treatment.
In the case of idiopathic scoliosis, which is the most common clinical condition, Cobb’s angle within 25-30° usually does not require bracing and surgery, and follow-up visits are conducted every 3 or 6 months depending on age. A brace is different from a brace in that it corrects scoliosis by applying support in the direction of the scoliosis. Once brace therapy is started, it should be worn 23 hours a day and reduced as appropriate according to follow-up until skeletal maturity, usually 17-18 years for males and 15-16 years for females. Do not forgo functional rehabilitation exercises during this period. If scoliosis is found to worsen during brace treatment, then surgery should be considered.