The majority of scoliosis is “idiopathic” meaning the cause is unknown. “It is responsible for 60 % of the cases.” However, scoliosis can have some genetic predisposition or familiar inheritance pattern. It also can be caused by various congenital abnormalities such as: muscular dystrophy, spina bifida, neuromuscular disease, cerebral palsy, or marfan’s syndrome. Most frequently this condition develops as “idiopathic” during middle or late childhood, during the growth spurt of early adolescence. Everyone’s spine has a natural curve. If the curve is less than 10 degrees, it is considered a postural curve. “Scoliosis is defined as a lateral curvature of the spine.” The spine of someone with scoliosis will have a “C” or “S” shape appearance rather than a straight line in that of a normal spine.
Usually screenings for scoliosis begin during preadolescents. The most important part of management is early detection of its presence, which may help to prevent the need for surgery. The assessment includes: observing the child’s back wearing underwear only (females can wear bra also), have child bend over at waist with arms hanging down which is called the Adam’s test. Using a scoliometer can assist to measure the degree of curvature of the spine. The nurse should observe for asymmetry in the scapula, flanks of the shoulders, ribs and hips. A history of poorly fitting slacks or skirts can be significant in the assessment of possible scoliosis. Other signs may include: uneven shoulder blades, a protruding scapula with one side of back higher than the other, protruding hip, hip and buttock asymmetry, misaligned truck or pelvis and obvious spinal curvature. To confirm the presence of scoliosis, spinal radiographs in a standing position can show the severity and the location of the spinal curve, and also use of the Cobb technique that establishes the degree of spinal curvature. The Risser scale is to evaluate skeletal maturity. The MRI and CT scan can also...
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