Scoliosis Research Paper

Idiopathic Scoliosis The spine is one of the most important structures of the human body. The spine serves various purposes. It consists of about thirty- three separate bones called the vertebrae which come from the Latin word “to turn”. The Spine which is also known as the vertebra supports our weight, holds us in a vertical position and supports our body movements. The vertebra plays an important function by protecting the spinal cord and nerves as they connect to all the other parts of the human body. There are four separate curves in a normal spine. Each curve contains a separate set of vertebrae. Located in the very top of the spine are called the cervical vertebrae. The next vertebrae are called the thoracic vertebrae which are found
in the chest area. The largest of the vertebrae provides aid to the upper body weight and is called the lumbar vertebrae. The word lumbar comes from the Latin word “loin”. The vertebrae that are located at the very bottom has two sets of small vertebrae called the sacrum and coccyx. The vertebral spine is a very complicated structure of the human body. It is surrounded with different ligaments and muscles that allow the body movements such as bending and straightening. In the vertebral column there are rubbery cylinders of cartilage called intervertebral discs. These discs absorb shocks, relieving the body from the numerous pressures of body movement. Even though these curves play an important role in having a healthy spine, some individuals have a sideways curvature of scoliosis. Scoliosis can happen in various cases such a birth defect, an accident or a muscular dystrophy.
However, the majority of cases in scoliosis are unknown. The term for this is called the idiopathic scoliosis. There are three separate forms based on the age of the person at the start of the curvature. The first form is the infantile form which is birth to three years old. The second form is the juvenile form which is four to ten years old scoliosis. Heredity may influence this condition and both genders share equally in the likelihood of getting this condition. Lastly, the adolescent form is ten to thirteen years old which is the most common form. Females are more three times more likely to be affected than
males. There are countless various types of curves in scoliosis. However, there are four major curve patterns that have the most concern. The right thoracic curve which is located in the chest area has a possibility to develop quickly. Therefore, it is important to have early treatment as soon as possible. As this condition develops, the ribs on the right side shift and create a rib hump which can live little space for the heart and lungs. This can lead to cardiopulmonary problems. Another curve is called the thoracolumbar curve. It starts in the same spot as the thoracic curve but, it ends farther down in the back called the lumbar region. There is a twist from either left or right and it is less deforming. The lumbar curve is far down in the region, creating a twist in the hips. The three curves have a c- shaped curvature of the spine. The double major curve has an s –shaped curvature and is the most common of that type. The curve starts in the thoracic area which is the chest while a second curve in the opposite direction located in the lumbar region. To get an accurate description to determine the angle formed from the curve, physicians use a technique that allows them to communicate accurately and have a measure with which to note the progression, remission or stabilization of the patient’s scoliosis. John Cobb who is an orthopedic surgeon, developed the well known used Cobb angle measurement. “His suggestion was to relate the top of the first and the bottom of the last vertebrae of a curve by determining the angle formed by the intersection of lines perpendicular to them. It is not difficult, using an X ray of the spine, to draw lines above and below the vertebrae, construct the required perpendiculars, and measure the angle of their intersection. In addition to degree of curvature, the complex structure of the spine shows rotation in scoliosis. The rotation causes the pedicles or indentations of the vertebrae to shift closer to the midline drawn on the X ray. The relative shift is described as a rotation of +1, +2, and so on.” (Magill’s Medical Guide, Sixth Edition Scoliosis)
Another diagnostic tool physicians use to determine the curvature of the spine is a simple plumb line is used to examine the patient’s back to determine any curvature in the spine. The physician should make the patient stand straight without bending knees. Then the forward bending test is being preformed. This observation is considered one of the most reliable diagnostic tools. Different forms of the curve can be seen by the physician. When viewed at eye level from both front and back, one side of the thoracic or lumbar regions is higher than the other. In addition, X-ray photographs are an important part of the diagnostic data.
There are various types of treatments for scoliosis. One can have none at all or have extensive surgery. Usually, treatments prevent the condition from getting worse. Braces and casts are most common and effective way to avoid scoliosis getting worse. A kinetic or active apparatus called the Milwaukee brace which is developed by Walter Blount and Albert Schmidt is a custom fit plastic brace that must be worn in day and night in order for it to be effective. It is also important to have exercise on a daily routine. Although it prevents it from progression, the condition won’t have correction. The brace can be removed for showering, swimming and other activities. Patients who have curves of 40 to 50 degrees, has pain, and has a progressed curve while being treated, surgery is the only way to prevent it from getting severe. Research shows that the correction is to be about 60 percent. Having scoliosis correction surgery can be risky because pressure is being applied to the spine thus creating a serious risk of damage to the spinal cord.
Once the patient agrees that surgery is the proper route of treatment, there are countless methods to choose from.
“The most common, and generally considered the safest, method is the Harrington rod technique. The incision is from the back (as opposed to front or side entries), and metal hooks are inserted at the highest and lowest points in the curve. These hooks hold metal rods used to straighten the spine and then to hold it in place. Small chips of bone are then taken from the hip or ribs and inserted between especially prepared vertebrae. In a period of six to eight months, solid bone will grow and fuse the vertebrae, giving a solid bone mass of a single elongated vertebra. After the surgery, the patient is usually placed in a brace or cast for four to six
months.” This relates to anatomy and physiology for several reasons. One reason why is because the vertebral column is part of the axial skeleton. It is the central part of the skeleton that supports the skull and protects the spinal cord. It also serves as attachment for the ribs, the pectoral and pelvic girdles. Another reason why it relates to anatomy and physiology is because this condition involves the different types of regions in the spine such as thoracic and lumbar regions. The last reason why is because the progression of scoliosis affects the regions of the spine and causing cardiopulmonary difficulties if not treated.