Question

Scoliosis

Lindy is a 12-year-old girl who recently noticed that her pants did not seem to fit her well. When she asked her mother to look at her back, her mother thought Lindy’s shoulders were uneven. Lindy’s mother made an appointment for Lindy to see her pediatrician. Lindy’s pediatrician did a complete examination and explained to Lindy and family that she has scoliosis.

1. Based on your knowledge of scoliosis and developmental stages, how would you explain scoliosis to a 12-year-old girl? Describe how to do a physical assessment for scoliosis. Lindy’s mother wants to know the treatment plan for Lindy. Lindy has a 30-degree curvature of the spine. What would you tell her? Keeping in mind the developmental age of the child, what would be a focus related to the therapy for this condition.

Answer 1

Scoliosis

Scoliosis is a condition in which there is abnormal lateral curvature of the spine.

1. Scoliosis for a 12 year old girl:

Scoliosis is a spinal abnormality in which there is a side ways curvature of the spine. It is a common disorder, mainly seen in children and adolescents. It usually occur just before puberty.   Different types of scoliosis are affecting the children, among which, the most common is Idiopathic scoliosis that affect adolescents. Each year approximately 3 million adolescents are diagnosed with Idiopathic scoliosis.

The cause of Idiopathic scoliosis is mostly unknown, but it runs in families and girls are affected more than boys. It occurs mainly when the children grows rapidly ( during pubertal period). It might be Asymptomatic or show uneven hips or shoulders. Most cases doesn't need treatment as the curves ma be small or wearing of a brace may correct the abnormality.

Physical Assessment for Scoliosis

Physical Assessment can reveal the abnormal curvature of spine. A nurse or a doctor can check the child's

* Posture: while standing , Doctor can check the level of shoulders and hip.

* While observing the back the curvature can be visible.

* Adam's forward bend test: child can bend forward with feet together, arms hanging free, knee straight , while observing ,the differences in shape of the ribs can reveal the scoliosis.

Treatment plan

Lindy has an abnormal spinal curvature of 30 degree. A 30 degree curvature is coming under the moderate category of Scoliosis, which doesn't need a surgical intervention . Instead She has to be in continuous monitoring with the help of x- rays. Any increase in curvature may need intervention of bracing , that helps to keep the spine straight as the child grows. bracing may help to correct the condition and it can prevent further worsening of the condition.

Surgical intervention required only when the child's condition is getting worse despite of all other efforts and interventions.

Focus of therapy:

* Correcting the deviation or reversing the curvature degree

* Preventing further progression of curvature

* Prevent future complications such as Pain and pulmonary dysfunctions.