Idiopathic scoliosis
The most common form of non-secondary spinal deformities is idiopathic scoliosis, which can not be attributed to other causes such as birth defects, neurological disorders, syndromes and connective tissue diseases, ie the cause of the scoliosis remains unclear.
The main feature is lateral deviation of the spine with rotation of the vertebrae, which increases towards the apex, and is responsible for the rib hump and / or lumbar bulge. Frequently an additional deformity in the sagittal plane with soncomitant lordosis or kyphosis.
The scoliosis became noticeable due to increasing deformation of the trunk with or without vertical deflection and depending on the location of the deformity , forming a rib hump and / or lumbar bulge, waist asymmetry of triangles and possibly shoulder inconsistency .
The experienced physician recognizes scoliosis already on physical examination. X-rays confirm the suspicion. The typical changes often occur during the growth spurt of puberty and four times more likely to affect girls than boys. Radiologically, the major and minor curvatures can be measured by the Cobb method. Based on the degree of severity of a case is determined.
Even mild scoliosis, should be taken seriously and the further course should be monitored closely by a doctor. Skoliosis less than 20 degree requires intensive physiotherapy treatment especially Lennert-Schroth. In addition, exercises should be carried out at home. All sports apart from highly upsetting exercises allowed.
Spinal curvatures greater than 20 degree which are still present in growth potency usually treated with a custom-made brace made of lightweight plastic (eg Chêneau brace). The brace must counteract the three-dimensional rotation of the spine. So that the treatment is effective, the corset must be worn as long as possible - usually 22 hours a day, including at night, which is not always easy for children and adolescents and often a motivation problem.
The success of the treatment must be regularly checked and the corset needs to be adjusted to the child's growth. In addition to the brace treatment physiotherapy exercises must be performed. This curvature can be reduced and it will train the abdominal and back muscles.
Because of the good surgical results in idiopathic scoliosis surgery is recommanded for angles greater than 40 degrees in lumbar and thoracolumbar scoliosis and more than 50 degrees in thoracic scoliosis, since beyond this angle even after growth completion a progression occurs.
