SCOLIOSIS

Scoliosis is a lateral curvature of the spine. The curvature may develop as a single curve (shaped like the letter "C") or as two curves (shaped like the letter "S"). Scoliosis occurs mainly in the thoracic and thoracolumbar regions. A mild degree of scoliosis is common, occurring in up to 50% of the population. Scoliosis is not usually painful. The frequency of back pain among patients with scoliosis is similar to that of the general population. Small curves occur with similar frequency in boys and girls, but progressive scoliosis affects a greater number of girls than boys.

Most cases of a mild scoliosis (less than 20 degrees) does not require any specific treatment but should be often checked. There may be offered advice on posture and exercises.

However, a severe scoliosis must be treated. A curve is significant if it is greater than 25 to 30 degrees. Curves of 45 to 50 degrees and more are severe and often require more aggressive treatment.

Scoliosis

Causes:

There are many causes of scoliosis, including:

• congenital spine deformity (which is due to a problem with the formation of vertebrae or fused ribs during prenatal development),

• neuromuscular problems (such as poor muscle control or muscular weakness or paralysis due to diseases such as cerebral palsy or muscular dystrophy),

• limb length inequality,

- genetic conditions.

Over 80% of scoliosis cases, however, are idiopathic, which means that the exact cause of scoliosis is not known. Most idiopathic scoliosis cases are found in previously straight spines and can occur at any age. Idiopathic scoliosis is divided into four categories based on age:

(1) infantile scoliosis: occurs in children less than 3 years old,

(2) juvenile scoliosis: occurs in children between the age of 3 and 10 and is not common,

(3) adolescent scoliosis: occurs between the age of 10 and 18 and is the most common form (it represents about 80% of idiopathic scoliosis cases). The scoliosis usually develops as the spine is growing rapidly (growth spurt).

(4) adult scoliosis: occurs after skeletal maturity.

Signs of scoliosis:

There are several common symptoms that may indicate scoliosis. Back pain is not usually a scoliosis symptom. Typically, symptoms of scoliosis include one or several of the following:

• Shoulders are at different heights

• One shoulder blade sticks out more than the other

• One hip is higher or sticks out more than the other

• The waist appears uneven

• There is a curvature in the spine

Signs of scoliosis

Diagnosis of scoliosis:

Scoliosis in the spine is often diagnosed with the test called the Adam's Forward Bend Test. For this test, the patient is asked to bend forward with his or her arms stretched downward toward the floor and feet together. This angle most clearly shows any asymmetry of the trunk or any abnormal spinal curvatures. To confirm the diagnosis and detect the extent of the curvature the X-

ray is ordered. The curve is then measured and is discussed in terms of degrees. After a diagnosis is made, a treatment plan is recommended.

Forward Bend Test

Treatment of scoliosis:

The type of treatment depends on the kind of the scoliosis, the degree and extent of the curvature (how severe the curve is), the location of the curve (thoracic curves are more likely to progress than thoracolumbar or lumbar curves) and the spinal maturity, that is, if the patient's spine is still growing. There are three basic types of treatments for scoliosis: observation, orthopaedic bracing and surgery.

(1) Observation: This option is appropriate when the curve is small (less than 20 degrees), the curve is at low risk of progression or if the person is near skeletal maturity. A regular X-ray examination is done to confirm that the curve is not progressing.

(2) Bracing: As curves get worse (above 25 to 45 degrees), bracing is recommended to slow the progression of the curve. The brace works by exerting pressure on the back and ribs to push the spine in a straighter position. There are many kinds of braces. The selection of a brace depends on the specific characteristics of the curve.

Scoliosis brace

(3) Surgery: If the curve is more than 45 degrees the surgery may be required because such large curves have a high risk of getting worse. Surgery involves correcting the curve and fusing the bones in the curve together by inserting metal rods along the spine.

Physiotherapy:

In the majority of scolioses, physiotherapists can give advice regarding:

• posture;

• strengthening of muscles and correction of muscle imbalance;

• exercise.

WORDLIST

adolescent - dorastający, osoba w wieku dorastania

brace - gorset ortopedyczny, aparat korekcyjny

cerebral palsy - porażenie mózgowe

confirm - potwierdzić

congenital - wrodzony

curvature - wygięcie, skrzywienie

curve - krzywa

degree - stopień

detect - wykryć

develop - rozwijać się

exert - wywierać

extent - zakres, rozmiar

growth spurt - okres przyspieszonego wzrostu

insert - włożyć, wstawić

infantile - niemowlęcy

juvenile - wczesnodziecięcy

muscular dystrophy - dystrofia mięśni

rod - metalowy wszczep, implant

skeletal maturity - dojrzałość kostna

uneven - nierówny

EXERCISES

I. Answer the questions.

1. What is scoliosis?

2. What kinds of neuromuscular problems can lead to scoliosis?

3. What does the term `idiopathic' mean?

4. What is the difference between juvenile scoliosis and adolescent scoliosis? Which is more common? Why?

5. What are the signs of scoliosis?

6. What is the “Adam's Forward Bend Test”? What can it reveal?

7. When is bracing recommended?

II. Decide whether the following sentences are true or false.

1. Scoliosis is a sideways curvature of the spine.

2. A mild scoliosis does not require any specific treatment.

3. Scoliosis occurs mainly in the cervical, thoracic and lumbar regions.

4. Back pain is a typical scoliosis symptom.

5. Scoliosis treatment is primarily centered on reducing or limiting the progression of the deformity.

6. The majority of cases of scoliosis have no known cause.

7. Juvenile scoliosis progresses mostly during the growth spurt.

8. Scoliosis treatment depends on the degree of the curvature.

III. Complete the sentences with the words form the text.

1. Humans take longer to reach _ _ t _ _ _ _ y than most other animals.

2. The bones of the skull are not properly _ u _ _ d at birth.

3. I had to wear a _ _ _ c _ for my crooked teeth when I was a teenager.

4. He staggered on the _ _ e _ _ _ surface of the car park.

5. He took a small key from his pocket and slowly _ _ s _ _ _ ed it into the lock.

6. The X-ray has _ _ t _ _ _ ed that he broken two ribs.

7. When John was 17, he died of _ _ _ g _ _ _ t _ _ heart disease.

8. Those especially vulnerable to calcium deficiency are women: _ d _ _ _ _ _ _ _ t girls and

middle-aged women.

IV. Find the words in the text which mean the following:

1. A type of radiation used by doctors to examine the bones or organs inside the body

2. A device that supports or holds in correct position a part of the body and can allow motion

3. A line which bends continuously and has no straight parts

4. A sudden increase in speed for a short while

5. Medical treatment in which someone's body is cut open so that a doctor can repair, remove, or replace

a diseased or damaged part.

V. Match the words to make word partnerships.

1. uneven a) the diagnosis

2. mild/severe/progressive b) curvature

3. exert c) spurt

4. skeletal d) palsy

5. recommend e) bracing

6. back f) examination

7. X-ray g) shoulders/hips

8. lateral h) pressure

9. confirm i) scoliosis

10. orthopaedic j) pain

11. cerebral k) maturity

12. growth l) treatment

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