SCOLIOSIS Kristy Rose, BSN, RN

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Scoliosis: Sideways curvature of the spine greater than 10° Most cases are idiopathic Genetic risk factors 3% of the US population >15° curvature, females are 5 times more at risk

Functional Scoliosis 2° to another abnormality in the body and can be corrected Posture, leg discrepancy Structural Scoliosis is a fixed condition most often idiopathic Idiopathic scoliosis can be classified as infantile, juvenile or adolescent Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis Children-for-Progressive-Infantile-Idiopathic- Scoliosis 14/02/the-1st-inningrewind.html

Pathophysiology changes occur with the muscles, ligaments and soft tissue shortening on the concave side of the cure d-chiropractic-weekly-scoliosis-screening- treatments-videos scoliosis-x-ray/ scoliosis/

Subjective findings: Scoliosis is asymptomatic Objective findings: Spinal deformity is the most common sign Adam Forward Bend Test One shoulder higher One shoulder blade higher/ more prominent One hip higher Space between arms and body greater on one side Leaning to one side Head is not centered directly over the pelvis

Schools screen students at 5 th & 8 th or 6 th & 8 th grade Referrals 4 newly diagnosed

The Gold standard for diagnosing scoliosis is by physical exam >10° diagnosed as scoliosis <25° observation only 25-35° bracing >40° surgery adults&language=english&depth=3 surgery-what-scars-and-recovery-look-real- patients-point-view

ADAM’S FORWARD BEND TEST Front Facing: shoulder, arm space, waist creases, hip levels Forward Bend: uneven contours, hump on one side Side Facing: Exaggerated roundness of upper or lower back Forward Bend: Uneven Contours, humps of one side Back Facing: Shoulder blade, waist creases, hip level, shoulder heights, curve spine, arm space Back Facing: Uneven contours, curved spine

PATIENT EDUCATION American Academy of Orthopaedic Surgeons- National Scoliosis Foundation- Scoliosis Research Society- Shriners Hospital for Children-Houston- Department of State Health Services- Sater, S., White, N, & Shriners Hospital for Children- Houston. (2007). School spinal screening guidelines. In collaboration with: Texas Department of State Health Services.

CONCLUSION Scoliosis is most often idiopathic by nature and progresses quickly. Diagnosis and treatment must be done at the prime time between 10 and skeletal maturity (which is individual for each patient). While only 3% of the population is affected by Scoliosis, it can often be over looked. The key is early diagnoses and early treatment! Do you think School Nurses Should continue to screen students? Senate Bill 504 passed 145 to 1 to allow Texas schools to choose whether to screen or send home scoliosis information. Governor Rick Perry Vetoed!!

REFERENCES Mahmound, R., & Krause-Parello, C.A. (2013). Idiopathic scoliosis: An overview for school and paediatric nurses. British Journal of School Nursing, 8(7), Retrieved from /ehost/command/detail?vid=5&sid=e02fb89a-ca91-4b66-a284-30fde0246c33%40sessionmgr113&hid=105&bdata =JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=rzh&AN= http://web.b.ebscohost.com.lcu.idm.oclc.org /ehost/command/detail?vid=5&sid=e02fb89a-ca91-4b66-a284-30fde0246c33%40sessionmgr113&hid=105&bdata =JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=rzh&AN= McCance, K.L., Huether, S.E., Brashers, V.L., & Rote, N.S. (2010). Alterations of musculoskeletal function in children. S.Clark, C.C. Jones, C. Ketchum (Eds.) Pathophysiology: The Biologic basis for disease in adults and children (1625 – 1628). Maryland Heights, Missouri: Mosby Elsevier. Sater, S., White, N, & Shriners Hospital for Children- Houston. (2007). School spinal screening guidelines. In collaboration with: Texas Department of State Health Services.