A handbook on Adolescent Idiopathic Scoliosis
A C-shaped spinal curvature bending to the left.
A backwards S-shaped spinal curvature bending to the right then left.
ACKNOWLEDGEMENT The production of this handbook would not have been possible without the contribution and efforts of: Ateneo de Manila University Glen Charles Lopez Dr. David Cabatan Jr. Gabriell Dae Ocampo Josephine Ocampo Nathan Lim
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A handbook on Adolescent Idiopathic Scoliosis
FOREWORD This handbook about Adolescent Idiopathic Scoliosis was written for you—to guide you as you start this journey of embracing yourself and your curves. We hope that the information provided will help you in understanding your condition and deepen your knowledge on the possibilites ahead. The information in this handbook is selective and does not cover all possible scenarios concerning the condition. This handbook is for general information and understanding only. Please consult your health care provider for specific information and questions about your condition. Research and Design by Kylah Naomi Ocampo
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TABLE OF CONTENTS The Spine The Spine Parts of the Spine Scoliosis What is Scoliosis Main Types of Scoliosis Scoliosis and Spinal Disorders Classification of Scoliosis Adolescent Idiopathic Scoliosis Who gets AIS Variations of Scoliosis Signs and Symptoms of AIS AIS Diagnosis Scoliosis Myths Treatments Treatments for Scoliosis Alternative Treatments Directory Glossary
9 10 12 14 17 18 22 26 28 30 38 45 48 50 54
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01
THE SPINE 8
WHAT IS THE SPINE? The spine (also called the vertebral column/spinal column) is composed of a series of bones called vertebrae stacked one upon another. It runs from the base of a person’s skull to the pelvis and serves as a pillar - supporting the body’s weight and protecting the spinal cord.
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PARTS OF THE SPINE The spine is made up of 24 individual bones called vertebrae that are separated by discs. The discs allow the spine to be flexible. There are 3 regions of the spine: 7 cervical (neck) vertebrae 12 twelve thoracic (chest) vertebrae 5 lumbar (low back) vertebrae In addition, there are 5 fused vertebrae below the lumbar spine that make up the sacrum. When viewed from the side, a spine has a natural S-shaped structure or curve. The curves work like a coiled spring to absorb shock, maintain balance, and allow range of motion throughout the spinal column.
1st Cervical 2 3 4 5 6 7 1st Thoracic 2 3 4 5 6 7 8 9 10 11 12 1st Lumbar 2
Cervical
Thoracic
Thorocolumbar
3 4
Lumbar
5
Sacrum Coccyx
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SCOLIOSIS 11
WHAT IS SCOLIOSIS? Scoliosis (pronounced sko-lee-osis) is a sideways curvature of the spine greater than 10 degrees. It is a musculoskeletal condition wherein the spine is abnormally rotated and curved sideways. Viewed from the front or back, the spinal column should be straight. However when scoliosis is present, a sideways shift of the spine to the right or left is seen.
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Scoliosis is a condition in which the spine has an abnormal side-toside “S-” or “C-” shaped curvature.
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3 MAIN TYPES OF SCOLIOSIS Scoliosis occurs and is treated as three main types: congenital, idiopathic and neuromuscular.
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Idiopathic scoliosis
This is the most common form and means with no definite cause. It mainly affects adolescent girls, but also appears in infants and juveniles.
Neuromuscular scoliosis
This type of scoliosis is associated with neuromuscular conditions like cerebral palsy, myopathy or spina bifida (myelomeningocele).
Congenital scoliosis
The least common form, is present at birth, and caused by a failure of the vertebrae to form normally.
SCOLIOSIS AND SPINAL ASYMMERTY Approximately 10 percent of the population has generally mild curves, which are of no consequence to function or health. This condition is called Spinal Asymmetry.
Curves less than 10 degrees are considered spinal asymmetry not scoliosis. Curves larger than this are often watched for its progression by X-ray measurement over time.
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Kyphosis 16
Lordosis
Scoliosis
SCOLIOSIS AND OTHER SPINAL DISORDERS There are naturally occurring curves in the spinal column aside from scoliosis when it is viewed from the side.
Kyphosis
Kyphosis, also known as roundback or hunchback is an exaggerated forward rounding of the back. It generally exists in the thoracic spine and may cause pain and disfiguration.
Lordosis
Lordosis is defined as an excessive inward curve of the spine. It may appear swayback, with the buttocks more prominent, and in general an exaggerated posture.
Scoliosis
Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. The cause of most scoliosis cases is idiopathic or unknown.
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CLASSIFICATION OF SCOLIOSIS A scoliosis curve is composed of both major (structural) and compensatory (nonstructural) curves. The major curve is the “real” scoliotic curve. It exhibits some degree of permanent curvature because the curve is rigid. Major curves also tend to be the largest curves. Here are three common types of scoliosis curves:
1. Single Major Curve
The term “single” implies that there is only one structural curve. Single right thoracic curves are the most common curve type.
2. Double Major Curve
A double major curve has 2 structural curves. An example is a double thoracic curve.
3. Triple Major Curve
A spine with 3 major curves is very rare. An example is a thoracic-thoracic-lumbar scoliosis.
To keep the spine balanced from side-to-side as possible, other sections of the spine may form a curve in the opposite direction of the major curve. This is what we call the compensatory curve, curves that remain flexible.
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Dextroscoliosis A backward C-shaped spine bending sideways to the right.
Levoscoliosis A C-shaped spinal curvature bending sideways to the left.
Height
Idiopathic scoliosis is also categorized by the age at which it begins to develop. Each age group has unique needs and challenges associated with treatment.
Age
0
3 Infantile
6 Juvenile
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15
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Adolescent
Adolescent scoliosis comprises approximately 80% of all idiopathic scoliosis cases. Adolescence is when rapid growth typically occurs, which is why the detection of a curve at this stage should be monitored closely for progression as the child’s skeleton develops. This is the focus of this handbook.
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03 ADOLESCENT IDIOPATHIC SCOLIOSIS 21
WHO GETS AIS? Adolescent Idiopathic Scoliosis (AIS) is a classification of idiopathic scoliosis, which means no known cause, mostly occurring in children ages 10 to 18. It is not rare, and mainly affects girls — many of whom have mild forms of the spinal condition.
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Idiopathic scoliosis is thought to be present in 2 to 3% of adolescents. About 1 in 500 of these will require active treatment namely observation and bracing and only 1 in 1000 have curves that progress to the degree where surgery is recommended.
CURVE PROGRESSION Girls and boys are equally affected by small degrees of scoliosis. Girls, however, are 8 times more likely to develop progressive curves.
recommended. However, many people simply need to have their spine checked regularly to make sure the curve isn’t getting bigger.
In curves between 11 to 20 degrees, there are more females with AIS than males. As the curves get bigger (greater than 20 degrees), so do the numbers of females with AIS compared to males.
Scoliosis curves more than 40 to 50 degrees have a higher risk of progression in adulthood and therefore must be monitored and treated during adolescent age. If a large deformity is not monitored or even treated into adulthood, complications may occur for the patient. These include pain due to compressed nerves or spinal cord or difficulty breathing due to lung and heart compression.
Scoliosis can worsen very quickly during adolescence because the child is growing fast at this time. If the curve is very big or growing very quickly surgery might be
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GENETIC FACTOR Idiopathic scoliosis is a genetic condition that is most common among girls. At this time, scientists continue to work to identify the specific genetic markers of DNA that indicate scoliosis. Several studies have shown that scoliosis develops within affected families with a higher incidence than in the general population. In one study, 27% of the daughters of women with scoliosis (curves greater than 15 degrees) were found to have scoliosis as well. Larger population studies in the 1960s and 1970s found incidences of 11%, 2.4% and 1.4% for first-, second- and third-degree relatives.
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About 40% of scoliosis cases are familial or based on genetics.
Because scoliosis can run in families, a child who has a parent, brother, or sister with idiopathic scoliosis should get checked for the conditon regularly by the family doctor.
RISK FACTORS FOR AIS Scoliosis is a progressive deformity and it is best to be prepared. Here are some of the factors that should be evaluated for the possiblity of curve progression.
1. Age
Signs of Adolescent Idiopathic Scoliosis may begin to manifest themselves with the onset of puberty, during the maximum growth spurt. Once the child has passed the peak of his/her growth spurt, the curve is less likely to have notable progess.
2. Gender
Girls are 5 to 8 times more likely than boys to develop scoliosis that requires active treatment. Similarly, girls are more likely to have the progressive condition.
3. Heredity
Idiopathic scoliosis tends to run in families.
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VARIATIONS OF SCOLIOSIS Before concluding that a person has idiopathic scoliosis, the doctor looks for other possible causes, such as injury or infection. Causes of curves are classified as either nonstructural or structural.
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Nonstructural (functional) scoliosis
A structurally normal spine that appears curved. This is a temporary, changing curve. It is caused by an underlying condition such as a difference in leg length, muscle spasms, or inflammatory conditions such as appendicitis. Doctors treat this type of scoliosis by correcting the underlying problem. For example, scoliosis due to muscle imbalance or poor posture can be treated through physical therapy.
Structural Scoliosis
A fixed curve that doctors treat case by case. Sometimes structural scoliosis is one part of a syndrome or disease. In other cases, it occurs by itself. Structural scoliosis can be caused by neuromuscular diseases, birth defects, injury, certain infections, tumors, metabolic diseases, connective tissue disorders, or unknown factors also known as, idiopathic.
Scoliosis is also sometimes described as mild, moderate, or severe, although it should be noted that these are not formal classifications.
Mild Scoliosis
Mild scoliosis generally is used to refer to cases where the Cobb angle is 20 degrees or less. Observation, watching & waiting, or perhaps exercises, are frequently recommended.
Moderate Scoliosis
Moderate scoliosis ranges between 20 to 40 degrees. It is at this stage that bracing is typically recommended for an adolescent who has not yet fully grown. Moderate scoliosis found after the growth spurt however, are advised to observe instead of brace.
Severe Scoliosis
Severe scoliosis is often used to refer to cases that are typically around 40 degrees or higher. Surgery is usually recommended in these cases.
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SIGNS & SYMPTOMS OF AIS Because of the many possible combinations of curvatures, scoliosis can be very different in different people. Screening will reveal common signs of scoliosis, including: 1. Uneven shoulder heights 2. Head not centered with the rest of the body 3. 4. 5. 6. 7. 8.
Uneven hip heights or positions One prominent shoulder blade Limb length inequality Clothing hangs unevenly Asymmetrical Crease When bending forward, the left and right sides of the back are asymmetrical
Idiopathic Scolisis is an asymptomatic and painless deformity. The child will have no weakness or movement problems because of the condition. Sometimes curves are obvious, but other times they aren’t immediately visible. Since scoliosis curves often aren’t painful and usually progress slowly, they tend to be overlooked until a child approaches puberty.
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Head not centered with body
Uneven shoulders
Unequal gaps
Uneven hip heights
One prominent shoulder blade
Limb length inequality
Spine obviously curved
Asymmetrical back
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AIS DIAGNOSIS: DETECTION Adams Forward Bend Test The Adams Forward Bend test, also known as the Forward Bend test or Adam’s test, is a common way to look for scoliosis in children. This test is used to make the spine visible to the observer, and curves or unevenness more obvious. The clinician can observe any unevenness in the hips, ribs or shoulder [or use a scoliometer to measure the degree of a curve.] If a curve measures more than 5-7 degrees on the scoliometer, it may be scoliosis. View spine from this angle to check for scoliosis
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This test is also used to determine whether the scoliosis is structural or nonstructural. If there is an asymmetrical height in the back, this means that the scoliosis is structural and could be AIS.
How to conduct the Adams Forward Bend test: Have the child stand with his/ her feet together with their back facing towards you. 2. Ask the child to relax and bend forward as far as they can go parallel to the ground. 1.
3.
Check for any signs of scoliosis such as uneven hip heights and spine curvature. Asymmetrical back heights will be most visible from this position.
X-Ray Examination An X-ray is a common imaging test that can help the doctor view the inside of the patient’s body without having to make an incision. An X-ray examination will be required to confirm the diagnosis of scoliosis and it should be done with the patient standing upright. Two pictures are usually taken of the spine, one from the back (posteroanterior or PA view) and one from the side (lateral view). To best assess the overall alignment of the spine, all regions of the spine should be included on a single film rather than obtaining individual films of each region.
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Once a problem is detected, doctors use medical and family history, physical exams and diagnostic tests to determine the nature and extent of scoliosis.
AIS DIAGNOSIS: EVALUATION Doctors take the following steps to evaluate patients for scoliosis:
Medical History The doctor talks to the patient and the patient’s parents and reviews his/her records to look for medical problems that might be causing the spine to curve, for example, birth defects, trauma, or other disorders that can be associated with scoliosis.
Physical Examination The doctor examines the patient’s back, chest, pelvis, legs, feet, and skin thoroughly. The doctor checks if the patient’s shoulders are level,
whether the head is centered, and whether opposite sides of the body look level. The doctor also examines the back muscles while the patient is bending forward to see if one side of the rib cage is higher than the other. If there is a significant asymmetry (difference between opposite sides of the body), the doctor will refer the patient to an orthopaedic spine specialist (a doctor who has experience treating people with scoliosis). Certain changes in the skin, such as so-called café au lait spots (the color of coffee with milk) can suggest that the scoliosis is caused by a birth defect rather than adolescent idiopathic scoliosis.
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X-Ray Evaluation The doctor may order X-rays to measure the spinal curvature of the patient. The angle of the curve, measured in degrees on the X-ray, will help the doctor decide whether it needs to be treated and, if so, how. X-rays also help determine the type of scoliosis and how mature the child’s skeleton is, which helps the doctor to predict if the scoliosis may progress. The X-ray might be repeated at regular intervals (sometimes every 3-12 months depending on the doctor) to check whether the curve is getting bigger or to monitor the effects of treatment.
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Curve Measurement The doctor measures the curve on the x-ray image. He or she finds the vertebrae at the beginning and end of the curve and measures the angle of the curve - this is what we call the Cobb Angle.
Cobb Angle
Cobb Angle
How to measure Cobb Angle
Cobb Angle is used worldwide to measure and quantify the magnitude of spinal deformities, especially in the case of scoliosis. The Cobb angle measurement is the “gold standard� of scoliosis evaluation endorsed by Scoliosis Research Society. It is used as the standard measurement to quantify and track the progression of scoliosis. It was also first described and named in 1948 by Dr. John R. Cobb after where he outlined how to measure the angle of the spinal curve.
1.
Locate the most tilted vertebra at the top of the curve and draw a parallel line to the superior vertebral end plate.
2. Locate the most tilted vertebra at the bottom of the curve and draw a parallel line to the inferior vertebral end plate. 3. Erect intersecting perpendicular lines from the two parallel lines. 4. The angle formed between the two parallel lines is Cobb angle.
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Doctors group curves of the spine by their location, shape, pattern, and cause. They use this information to decide how best to treat the scoliosis.
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Location
To identify a curve’s location, doctors find the apex of the curve (the vertebra within the curve that is the most off-center); the location of the apex is the “location� of the curve. A thoracic curve has its apex in the thoracic area (the part of the spine to which the ribs attach). A lumbar curve has its apex in the lower back. A thoracolumbar curve has its apex where the thoracic and lumbar vertebrae join.
Shape
The curve usually is S- or C-shaped.
Pattern
Curves frequently follow patterns that have been studied in previous patients. The larger the curve is, the more likely it will progress (depending on the amount of growth remaining).
Mild Curve
Moderate Curve
Severe Curve
10-20 degrees
20-40 degrees
40+ degrees
Done Growing?
Done Growing?
Done Growing?
Yes
Yes
No
Yes
No
Observation (Monitor every 3-5 years)
No Treatment
Observation (Monitor with Exam or X-Ray)
Careful Observation; Consider Surgery
Bracing Recommended
Treatments based on curvature and growth
No
Surgery Recommended
Doctors also consider the severity of the curve and the remaining growth left for the patient in order to decide the best treatment for their scoliosis.
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SCOLIOSIS MYTHS 38
Myth # 1
Scoliosis can be reversed. No, scoliosis (AIS) cannot be reversed through mere observation, physical therapy, chiropractic manipulation nor even bracing. It is only through surgery that the curvature can be reversed however, not all patients are advised to seek this treatment. There are 2 types of scoliosis - Non structural and structural. Non structural scoliosis are temporary and are caused by an underlying condition such as difference in leg length or muscle imbalance. This type of scoliosis can be reversed through physical therapy as it is dependent on different underlying
conditions. However, this is not applicable to AIS. Structural scoliosis, which can be rooted to the actual deformity in the bone, on the other hand, cannot be reversed through physical therapy. Adolescent Idiopathic Scolioisis is a structural scolioisis. Physical therapy can ease the discomfort but not correct the curve of the spine. Treatments like physiotherapy and exercise routines can help with pain, improve posture and flexibility but will not reduce the size of a curve or slow down the worsening of the curve. In addition, bracing can only prevent the curve progression of the spine but not reverse it.
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Myth # 2
Backpacks worsen scoliosis. No, carrying heavy backpacks do not worsen or affect scoliosis. Neither does carrying handbags, shoulder bags, or not drinking enough milk. In most cases, there is no definite cause or way to prevent the spine’s failure to grow as straight as it should. Scoliosis is a spinal abnormality—it’s neither a cause nor a result of improper use of a backpacks or shoulder bags. Scoliosis isn’t caused by anything that the child did or didn’t do.
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Myth # 3
Scoliosis is painful. Yes and No. Most of the time, scoliosis is more of a cosmetic challenge than a health challenge. It is asymptomatic which means that the spinal condition does not manifest any symptoms including pain. In more severe cases however, a child’s bones may twist in a way that puts the organs at risk. In these situations, scoliosis can cause pain since the organs and muscles around the spine are affected by scoliosis. It is the agitated organs and muscles that bring about pain.
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Myth # 4
Scoliosis patients cannot do sports. No, scoliosis pateints are actually highly encouraged to excercise and participate in sports. Exercise is encouraged in patients with scoliosis to minimize any potential decrease in functional ability over time. Staying active is important to the child’s overall health. There are no exercises, sports or activities that will make scoliosis worse or better.
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Myth # 5
Scoliosis patients cannot get pregnant. No, pregnancy will have no ill effect on the condition and vice versa. Having scoliosis does not mean that the patient will not be able to have children or will have trouble with a normal birth. Scoliosis has no effect on conception and in most cases women with this condition have no problems with pregnancy and labour. The patient however, should still keep her doctor and anaesthetist informed beforehand to ensure that she has a safe and comfortable delivery.
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TREATMENTS 44
TREATMENT FOR SCOLIOSIS The doctor will suggest the best treatment for each patient based on the patient’s age, how much more he or she is likely to grow, the degree and pattern of the curve, and the type of scoliosis. The doctor may recommend observation, bracing, or surgery.
Observation and Monitoring Once an abnormal spinal curve has been detected, it’s important to monitor it closely as the child grows. Observation means that the patient will be regularly checked by the scoliosis specialist, who will perform an exam and take x-rays every 4 to 12 months. The frequency of visits is based on the patient’s stage of growth.
Observation is usually advised and recommended for patients who are still growing with curves that measure less than 20 to 25 degrees and for patients who have finished growing with curves that measure 40 to 45 degrees. There are a few different scenarios for scoliosis curves in the 20 to 40 degree range:
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1. If growth is finished and the curve has progressed but is less than 40 degrees, there is little risk of the curve continuing to progress in adulthood. Curves over 45 degrees are more likely to progress and should be monitored periodically. 2. If the patient is still growing and the curve has progressed but is still in the non-operative range (less than 45 to 50 degrees), bracing with close observation may be considered.
Bracing If the growing patient’s curve exhibits significant worsening or is already greater than 25 degrees, a bracing program may be recommended. Bracing is a treatment protocol in which the
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patient is referred by the doctor to an orthotist, a bracing specialist, who will evaluate, design, and fit an external support brace in an attempt to stabilize progressive curves. The primary goal of bracing patients with AIS is to halt curve progression. Although it rarely leads to a significant or permanent decrease of the curve, a successful course of bracing might prevent the need for surgery.
Doctors advise patients to have surgery to correct a curve or stop it from worsening when the patient is still growing, has a curve that is more than 50 degrees, and has a curve that is getting worse. The most common surgical procedure for treating spinal problems in adolescents is spinal fusion and instrumentation combined to help correct and solidify the curve.
The scoliosis brace is usually worn underneath clothing and worn for a period of time, usually about 2224 hours a day.
Surgery In more severe cases, surgery can help correct spinal problems.
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ALTERNATIVE TREATMENTS Some people have tried other ways to treat scoliosis, including manipulation by a chiropractor, electrical stimulation, dietary supplements, and a lot of corrective exercises. There is no scientific data that proves these alternative methods will affect the natural history of scoliosis, but there is no evidence that they do harm either.
Physical Therapy Physical therapy may address any pain and imbalance experienced that can be associated with spinal abnormalities.
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Chiropractic Manipulation Chiropractors are health care professionals primarily focused on the diagnosis and treatment of any neuromuscular disorders, with an emphasis on treatment through manual adjustment and/ or manipulation of the spine. These chiropractic adjustments and therapies help improve form (therefore, improving function), and induce mobility into the joints. These adjustments can decrease pain, increase the patient’s comfort and improve their posture. Chiropractors can
also address other symptoms or issues they may be experiencing and increase their quality of life.
Electrical Stimulation Electrical stimulation is applied, with skin electrodes, to the muscles between the ribs on the side of the chest or torso, directly under the arm. The electrodes are placed so that contraction of the muscles has the greatest effect on the apex of the curve. Electrical stimulation is usually employed at night, during sleeping hours. The stimulation is cycled on and off for up to eight hours each night.
Dietary Supplements Following a balanced diet will help scoliosis patients feel better.
However, diet and nutrition alone will not help prevent or treat scoliosis. In the meantime, it is vital to have a calcium-rich diet and vitamin D to help aid bone growth and prevent osteoporosis.
Corrective Excercises Studies have shown that exercise alone will not stop progressive curves. It may however, have positive effects on the patient’s general health and help alleviate pain through exercises on proper prosture correction. Core strengthening exercises are highly recommended for scoliosis patients such as proper sit-ups or swimming. Good posture habits are also encouraged like refraining from crossing one’s legs.
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DIRECTORY 50
DOCTORS
Orthopedic Surgeons, Specializing in Spinal Surgery
Vicente R. Gomez, MD
David Cabatan Jr., MD
Makati Medical Center
Cardinal Santos Medical Center
Room 150, 2 Amorsolo Street, Legaspi Village Makati City, Metro Manila
Room 146, Medical Arts Building, 10 Wilson St., Greenhills West, San Juan City, Metro Manila
(+632) 888 8999 local 2150 Monday 2:00pm-5:00pm Friday 2:00pm-5:00pm
Jose Martin S. Paiso, MD
(+632) 727 0001 to 17 local 2146 Direct Line: (+632) 571 5889 Monday 9:00am-12:00nn Wednesday 4:00pm-6:00pm Friday 9:00am-12:00nn
St. Luke’s Medical Center
Makati Medical Center
Suite 1218-1219, Medical Arts Building, 32nd St. and 5th Ave., Bonifacio Global City, Taguig City, Metro Manila
Room 1, 2 Amorsolo Street, Legaspi Village Makati City, Metro Manila
(+63) 906 488 4904 Monday 3:00pm-5:00pm Friday by appointment
(+632) 888 8999 local 2174 Monday 2:00pm-5:00pm Wednesday 9:00am-11:00am
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HOSPITALS & INSTITUTIONS Philippine General Hospital Department of Orthopedics University of the Philippines Manila Taft Avenue, Manila, Metro Manila
Direct Line: (+632) 554-8466 Trunk Line: (+632) 554-8400 locals 6300, 6303 & 6304
Philippine Orthopedic Institute, Inc. 2/F Don Jacinto Building, Dela Rosa cor. Salcedo Streets, Legaspi Village, Makati City, Metro Manila
Direct Line: (+632) 892 1541 to 43 Emergency Line: (+63) 917 584 4374
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Philippine Orthopedic Center Department of Health Maria Clara St, Santa Mesa Heights, Quezon City, Metro Manila
Direct Line: (+632) 711 4276
St. Luke’s Medical Center Institute of Orthopedics and Sports Medicine 32nd St. and 5th Ave., Bonifacio Global City, Taguig City, Metro Manila
Direct Line: (+632) 789 7700 Emergency Line: (+632) 789 7810
SUPPLIERS
Orthotics, Bracing equipment suppliers
Ed Oliveros, MD of ScolioCare Corporation
Orthopaedie Frey Far East, Inc.
Pediatric & Adult Bracing
Bracing & Shoe Inserts
Olympic Heights Tower 3, Eastwood City, Bagumbayan, Libis, Metro Manila
3 San Lucas Street. Barangay Kapitolyo, Pasig City, Metro Manila
Direct Line: (+63) 917 303 2163 Email: physicaltherapy@peakospt.com
Ana Paula Lim, MD of ScolioCare Corporation Pediatric Bracing Philippine Rehabilitation Institute 56 Banawe Street, Quezon City, Metro Manila
Direct Line: (+632) 634 2705 or (+632) 637 7613 Fax: (+632) 634 4734 Email: orthofrey@yahoo.com Office Hours: Tuesday to Friday 9:00 am to 5:00pm Saturday 9:00 to 4:00pm Website: http://orthofrey.org
Direct Line: (+63) 917 620 3706 Email: paulalim@yahoo.com
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GLOSSARY Adams Forward Bent test
Dextroscoliosis
A screening tool for scoliosis.
A backward C shaped spine bending sideways to the right.
Adolescent Idiopathic Scoliosis AIS is a classification of idiopathic scoliosis—mostly occurring in girls ages 10 to 18.
Brace, bracing For curves greater than 30 degrees, a physician may recommend a bracing program, in which a brace is designed specifically for a particular curve. The brace holds the spine in a straighter position while the child or teen grows in order to partly correct the curve or prevent it from increasing.
Cobb Angle A measurement of the magnitude of spinal deformities.
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Idiopathic Scoliosis The most common form of scoliosis. “Idiopathic” simply means that there’s no known cause. Nothing a parent or child did caused the problem, and there’s nothing anyone could have done to prevent it.
Levoscoliosis A C-shaped spinal curvature bending to the left.
Nonsrtuctural Scoliosis This is a temporary, changing curve. It is caused by an underlying condition such as a difference in leg length or inflammatory conditions.
Orthopedics The medical specialty responsible and concerned with diagnosing, treating, rehabilitating and preventing any disorders and injuries to the spine, skeletal system and associated muscles, joints and ligaments.
Orthopedic Surgeon, Orthopedist A physician specializing in surgical and non-surgical treatment of the spine, skeletal system and associated muscles, joints and ligaments.
Orthotics The science of designing and fitting of devices such as braces to treat orthopedic conditions.
Progression, Curve Progression Worsening of a scoliosis curve.
Scoliosis
greater than 10 degress. Scoliosis can either be C-shaped or S-shaped.
Structural Scoliosis A fixed curve that doctors treat case by case. Sometimes structural scoliosis is one part of a syndrome or disease. In other cases, it occurs by itself.
Spinal Cord A nerve bundle within the vertebral column that extends down from the brain stem. It conducts signals in both directions between the brain and extremities, and allows for bodily motion and sensation.
Spine, Spinal or Vertebral Column Composed of a series of bones called vertebrae stacked one upon another. It serves as a pillar - supporting the body’s weight and protecting the spinal cord.
A sideways curvature of the spine
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SOURCES
All information & content found in this handbook were collated and referenced from the following sources.
Adolescent Idiopathic Scoliosis [PDF]. (n.d.). Illinois: North American Spine Society. Adolescent Idiopathic Scoliosis: Navigating your Journey [PDF]. (2015). San Diego, California: Setting Scoliosis Straight Foundation. Anatomy of the Spine [PDF]. (2016). Cincinnati, Ohio: Mayfield Brain & Spine. Baaj, M. A. (2017, January 26). Scoliosis: What You Need to Know. Retrieved March 09, 2017, from http://www.spine-health.com/conditions/scoliosis/scoliosis what-you-need-know Boos, N., & Aebi, M. (Eds.). (2008). Spinal Disorders: Fundamentals of Diagnosis and Treatment. Campbell, J. M. (Ed.). (2002). ES In Idiopathic scoliosis [idiopathic spine deformity]. Retrieved March 09, 2017, from https://www.ifess.org/cedu_scoliosis Clear Scoliosis Institute. (2017). Learning About Scoliosis. Retrieved March 09, 2017, from https://www.clear-institute.org/learning-about-scoliosis/ Cherney, K. (2013, August 16). Diet and Nutrition for Scoliosis. Retrieved March 09, 2017, from http://www.livestrong.com/article/382678-diet-and-nutrition for-scoliosis/ Core Concepts. (2016). Cobb Angle and Scoliosis. Retrieved March 09, 2017, from https://www.coreconcepts.com.sg/article/cobb-angle-and-scoliosis/
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Mayo Clinic Staff. (2014, June 06). Kyphosis. Retrieved March 09, 2017, from http:// www.mayoclinic.org/diseases-conditions/kyphosis/basics/definition/con 20026732 Mayo Clinic Staff. (2016, March 08). Scoliosis. Retrieved March 09, 2017, from http:// www.mayoclinic.org/diseases-conditions/scoliosis/home/ovc-20193685 Questions & Answers about Scoliosis in Children and Adolescents [PDF]. (2008). Bethesda, Maryland: National Institute of Arthritis and Musculoskeletal and Skin Diseases. Regan, J. J., MD. (2015, September 08). A Closer Look at Lordosis. Retrieved March 09, 2017, from https://www.spineuniverse.com/conditions/spinal-disorders/ closer-look-lordosis School Nurse’s Guide to Scoliosis [PDF]. (2012). Boston: Boston Children’s Hospital. Scoliosis Association (UK). (2016). Scoliosis: The truth about common myths. Retrieved March 09, 2017, from http://www.sauk.org.uk/scoliosis-information/ scoliosis-the-truth-about-common-myths Scoliosis Research Society. (2017). Frequently Asked Questions. Retrieved March 09, 2017, from http://www.srs.org/patients-and-families/common questions-and-glossary/frequently-asked-questions The Nemours Foundation. (2014, May). X-Ray Exam: Scoliosis. Retrieved March 09, 2017, from http://kidshealth.org/en/parents/xray-scoliosis.html? WT.ac=p-ra Yeomans, S. G., GD. (2013, March 14). What is a Chiropractor? Retrieved March 09, 2017, from http://www.spine-health.com/treatment/chiropractic/what-a chiropractor
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A S-shaped spinal curvature bending to the left then right.
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A backwards C-shaped spinal curvature bending to the right.
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