As parents, one of the things we need to look out for and understand is childhood scoliosis. We may not be familiar with this medical condition; hence it is an opportune time to learn more about it from Assoc. Prof. Dato’ Dr. Mohd Hisam, Orthopaedic & Trauma Surgery, Spine Surgery, UKM Medical Centre.
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Let’s get on to it, and learn some useful insights on scoliosis, and share this information with other mummy friends out there, too!
Q1: What is scoliosis?
Scoliosis is a lateral or side to side bending of the spine. However, this definition is not very accurate, as the side-to-side bending is also associated with rotation of each spine segment, making this a three-dimensional deformity rather than just a side-to-side deformation.
This rotational element is responsible for the associated cosmetic appearance of a “rib hump” or a small hump in side of the spine, which is more noticeable as the patient bends forward. This hump is used for a screening test in scoliosis known as the Adam forward bending test.
Q2: Are people born with scoliosis, or does it develop?
Scoliosis has many etiological causes. When you are born with scoliosis, it is called congenital scoliosis. This is usually a bony malformation of vertebrae that forms the spine. It can be a malformation failure like unsegmented spinal vertebrae, or more commonly a hemivertebrae where only half of the vertebrae is formed.
Another form of scoliosis is neuromuscular form, which is usually associated with spinal cord malformation. Our spinal cord is housed by the spine, which is a body of electrical wiring system that connects our impulses from our brain to our muscles, etc.
Majority of scoliosis cases fall under the idiopathic scoliosis category. This type of scoliosis constitutes about 80 percent of the cases. Idiopathic scoliosis is diagnosed after excluding all the known causes of scoliosis.
The most common type of idiopathic scoliosis is the adolescent idiopathic scoliosis, which develops when a child is at the growth spurt stage. To date, we do not know the exact cause as to why certain children develop idiopathic scoliosis. There is also a small chance of familial tendency to develop this form of scoliosis.
Q3: At what age is scoliosis usually diagnosed?
Since scoliosis is usually painless and develop gradually over time, it is usually a problem that is not detected. Therefore, as parents, we have to monitor our child well as scoliosis commonly develops during the child’s growth spurt around the ages of 11-14 in girls, and 12-15 in boys.
Q4: What are the signs of scoliosis in children?
The easiest way to detect scoliosis is to examine your child’s back as he or she stands against the wall, like how you would measure their height. Look for level of the shoulder and the pelvic area. They should be equal on right and left.
Next, look out for any asymmetry in the shape of the torso. Then, ask the child to bend forward and look for any asymmetry on the ribs, or the presence of rib hump when they bend forward.
Finally, measure their height. Keep note of their height progression. This “vertical height” should correspond to the arm span of the child. If you notice your child’s height has reduced from the last measurement, or evidence of asymmetry of the trunk, shoulder, and pelvic area with the presence of a hump when they bend down, you should have your child checked up.
Q5: Can a child grow out of scoliosis, or will it worsen with age?
Usually, serial clinical and radiology examination of the spine is needed to be able to determine this. It also depends on the stage of scoliosis that the child has developed. If it is detected before the growth spurt, then there is a higher chance of scoliosis progression. If it is developed at the end of the child’s growth cycle, then it normally does not progress very fast.
Finally, it also depends on the degree of the scoliosis at the end of the growth. If your child is at less than 25 degrees at end of the growth, this normally does not progress and will not have any effect in adulthood. If at end of growth it’s about 40 degrees, then it will progress but at a very slow rate, roughly 0.7-1.2 degrees per year, depending on the location of the curve. Curves between 25-40 may or may not progress.
Q6: Is there a cure for scoliosis?
Currently, there is no cure. I don’t consider surgery as a cure. If your child needs surgery, it will be a trade-off between a mobile spine and a straight but stiff spine. However, not all scoliosis needs to be operated upon.
Q7: What kinds of exercises are suitable for kids or adults with scoliosis?
In the case of scoliosis where the spine bends side to side, the muscles along the sides of the spine will usually be longer on one side and shorter on the other side. Therefore, exercises that’s good will result in a better balance between these muscles.
These muscles are also part of the core muscles, hence it’s good to strengthen the core muscles, too. A good way is to do side to side stretches. Examples of good strengthening exercises are planks, side planks, and if you have a swimming pool, swimming is also good. Exercises have to be maintained throughout your life to maintain healthy back muscles.
Q8: Is there anything children with scoliosis should avoid?
Nope! You should allow your child to enjoy their childhood without any limitations of their capabilities.
Q9: What helps with scoliosis pain?
Majority of scoliosis cases is painless. If it becomes painful, it needs to be investigated further. However, as they go into adulthood, they may start to have back pain from spinal and muscular imbalance. Therefore, the exercises I have mentioned earlier will be good. Maintaining good core muscles helps to reduce back pain, whether you have scoliosis or not.
Q10: What are some of the things you feel parents should know if their child has scoliosis?
A child with scoliosis is special! They are usually very smart and academically an overachiever. However, they may feel inferior as they will think that they have a deformed spine. Hence, we must first maintain the emotional health of our scoliosis child.
A child with scoliosis must not be treated as an ‘OKU’ (‘orang kurang upaya’ or ‘persons with disabilities’, in English) as they can do and achieve many things in life. Help your child to maintain a good exercise regime. And in the low likelihood where your child needs surgery, please know that even if it is a complex major surgery, it can be done very successfully, with very low complication rate. There are adequate expertise and modern equipment available for surgically treated patients.
Source: Assoc. Prof. Dato’ Dr. Mohd Hisam, Orthopaedic & Trauma Surgery, Spine Surgery, UKM Medical Centre
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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