GET THE FACTS ABOUT SCOLIOSISI.M. Doctor, M.D.

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The information in this presentation was provided to the presenter by the American

Academy of Orthopaedic Surgeons and may be modified.

Endorsement of this presentation by the AAOS

is not implied or inferred.

Thank you to members of the Pediatric Orthopaedic Society of North America

and the Scoliosis Research Societyfor contributions to the

content of this presentation.

Get the Facts About Scoliosis

Orthopaedics and the Bone and Joint Decade

Scoliosis

What is an orthopaedic surgeon?

MD who specializes in treatment and health maintenance of musculoskeletal system (bones, joints, ligaments, muscles, tendons, cartilage and spine)

What is an orthopaedic surgeon?

The expert in treating the musculoskeletal system

The expert in maintaining musculoskeletal health

Educating an Orthopaedic Surgeon

College Medical School Internship Orthopaedic Residency Fellowship (optional) 2 Years Practice

TOTAL

4414(1)2

16 years!16 years!

What do orthopaedic surgeons do?

Diagnose Treat

Medication Physical Therapy Exercise Brace Surgery

Prevent

Part of AAOS commitment to Bone and Joint Decade

Resource for doctors and clinicians Focus on conditions with greatest

burden/cost to society Resource for health care policy makers

Improving Musculoskeletal Care in America (IMCA)

Get the Facts About Scoliosis

Your Orthopaedic Surgeon

Getting You Back In The Game

What is scoliosis?

Side-to-side curve of spine

Can cause misalignment of shoulders or hips

Who is affected?

Infant scoliosis: under 3 Juvenile scoliosis: age 3-10 Adolescent scoliosis: 10+ Adult

Infant Scoliosis

Abnormally shaped vertebrae at birth (congenital scoliosis)

Syndromes or neurological disorders Unknown reasons

Juvenile Scoliosis

20% of curves of >20 degrees are due to underlying medical cause

In many cases, cause is unknown This group accounts for 10-15% of

children’s cases with unknown causes

Adult Scoliosis

May be the result of aging or medical problem

May have been present since childhood Often diagnosed when patient feels pain

or loss of function

Adolescent Scoliosis

Occurs after age 10, before growth stops Often has no known cause (idiopathic) Most common type

What causes scoliosis?

Cause is usually unknown May be the result of birth

defects and other medical conditions

Sometimes runs in families

What causes scoliosis?

Scoliosis is NOT caused by: Physical activity Carrying heavy things Bad posture Sleep position Lack of calcium

Who is affected?

Curves occur equally in boys and girls

Girls more often require treatment

Racial/ethnic groups equally affected

Diagnosing Scoliosis

Visual screenings:

Visual check by school nurse

More complete exam by physician

Diagnosing Scoliosis

X-rays confirm physician’s diagnosis

CT scan or MRI may be recommended to make things clearer

Treating Scoliosis

Orthopaedic surgeons take care of muscle and bone problems

An orthopaedic surgeon with special training in children’s spine problems will best be able to treat scoliosis

Treating Scoliosis

Orthopaedics =“Straightening the child”

Treating Scoliosis

Complementary practices: Can help patients feel better

overall Can help strength and

flexibility

Treating Scoliosis

Complementary practices: Should not replace

traditional medical care Beware of practitioners

offering “cures”

Treating Scoliosis

Observation Back brace Surgery

Treating Scoliosis: Observation

Curves of <20 degrees in growing children

Curves of <40 degrees in older patients

Treating Scoliosis: Observation

Ongoing x-rays are taken to measure the curve and determine whether it is changing

Treating Scoliosis: Bracing

Does not correct curve —only prevents worsening

For patients with 20-40 degree curves

Treating Scoliosis: Bracing

Selected for specific patient and condition Milwaukee brace (Cervico-

Thoraco-Lumbo-Sacral-Orthosis)

Boston brace (Thoraco-Lumbo-Sacral-Orthosis or TLSO)

Charleston bending brace

Treating Scoliosis: Bracing

Must be worn for certain number of hours every day

ALWAYS follow orthopaedic surgeon’s instructions

Treating Scoliosis: Bracing

“Time off” from brace can be used for sports or similar activities

Brace should be worn every day until child stops growing

Treating Scoliosis: Surgery

May be recommended for children with curve of >45 degrees

If patient is done growing, may be recommended if curve is >50 degrees

Treating Scoliosis: Surgery

Implants and bone grafts straighten and fuse the spine

Surgery is the only treatment that will straighten the spine

Treating Scoliosis: Surgery

Potential risks include: Nerve/spinal cord injury Healing problems Hardware problems

Treating Scoliosis: Surgery

Walk without brace: 2-3 days

Discharge from hospital: <7 days

Return to sports: 6-9 months

Living With Scoliosis: Nutrition

Eat a healthy diet, with 1,000 i.u. of vitamin D and 1,300 mg of calcium

Eat calcium-rich foods

Living With Scoliosis: Nutrition

Maintain a healthy body weight

Absolutely NO SMOKING

Living With Scoliosis: Exercise

Can help maintain strength and flexibility

Can help minimize discomfort and loss of function

Living With Scoliosis: Exercise

Aerobic sports recommended

Focus on flexibility and core strength

High-impact sports may be restricted

Living With Scoliosis: Exercise

Exercise cannot correct scoliosis

Avoid any practitioner who makes such claims

Living With Scoliosis: Exercise

Consult with your orthopaedic surgeon before beginning any exercise program

Living With Scoliosis

Curving often slows or stops in adulthood

Most normal activities are safe Pregnancy and childbirth usually

safe Follow up with orthopaedic

surgeon

Living With Scoliosis

Every patient and every case is different

Treatment is customized to your needs

Ask question, stay informed

Partner with your orthopaedic surgeon

American Academy of Orthopaedic Surgeons

6300 North River RoadRosemont, IL 60018

orthoinfo.org

Pediatric Orthopaedic Society of North Americaposna.org

Scoliosis Research Societysrs.org

Resources

What are your questions and concerns?

Get the Facts about Scoliosis

Get the Facts about Scoliosis

Thank you for participating today Remember, your orthopaedic

surgeon can help get you back in the game