1. GET THE FACTS ABOUT SCOLIOSIS I.M. Doctor, M.D. My Office My City, State

2. The information in this presentation was provided to the presenter by the American Academy of Orthopaedic Surgeons and may be modified. Endorsement of this presentation by the AAOS is not implied or inferred. Thank you to members of the Pediatric Orthopaedic Society of North America and the Scoliosis Research Society for contributions to the content of this presentation.

3. Get the Facts About Scoliosis Orthopaedics and the Bone and Joint Decade Scoliosis

4. What is an orthopaedic surgeon? MD who specializes in treatment and health maintenance of musculoskeletal system (bones, joints, ligaments, muscles, tendons, cartilage and spine)

5. What is an orthopaedic surgeon? The expert in treating the musculoskeletal system The expert in maintaining musculoskeletal health

6. Educating an Orthopaedic Surgeon College Medical School Internship Orthopaedic Residency Fellowship (optional) 2 Years Practice TOTAL 4 1 4 (1) 2 16 years!

7. What do orthopaedic surgeons do? Diagnose Treat Medication Physical Therapy Exercise Brace Surgery Prevent

8. Part of AAOS commitment to Bone and Joint Decade Resource for doctors and clinicians Focus on conditions with greatest burden/cost to society Resource for health care policy makers Improving Musculoskeletal Care in America (IMCA)

9. Get the Facts About Scoliosis Your Orthopaedic Surgeon Getting You Back In The Game

10. What is scoliosis? Side-to-side curve of spine Can cause misalignment of shoulders or hips

11. Who is affected? Infant scoliosis: under 3 Juvenile scoliosis: age 3-10 Adolescent scoliosis: 10+ Adult

12. Infant Scoliosis Abnormally shaped vertebrae at birth (congenital scoliosis) Syndromes or neurological disorders Unknown reasons

13. Juvenile Scoliosis 20% of curves of >20 degrees are due to underlying medical cause In many cases, cause is unknown This group accounts for 10-15% of childrens cases with unknown causes

14. Adult Scoliosis May be the result of aging or medical problem May have been present since childhood Often diagnosed when patient feels pain or loss of function

15. Adolescent Scoliosis Occurs after age 10, before growth stops Often has no known cause (idiopathic) Most common type

16. What causes scoliosis? Cause is usually unknown May be the result of birth defects and other medical conditions Sometimes runs in families

17. What causes scoliosis? Scoliosis is NOT caused by: Physical activity Carrying heavy things Bad posture Sleep position Lack of calcium

18. Who is affected? Curves occur equally in boys and girls Girls more often require treatment Racial/ethnic groups equally affected

19. Diagnosing Scoliosis zVisual screenings: yVisual check by school nurse yMore complete exam by physician

20. Diagnosing Scoliosis X-rays confirm physicians diagnosis CT scan or MRI may be recommended to make things clearer

21. Treating Scoliosis Orthopaedic surgeons take care of muscle and bone problems An orthopaedic surgeon with special training in childrens spine problems will best be able to treat scoliosis

22. Treating Scoliosis Orthopaedics = Straightening the child

23. Treating Scoliosis Complementary practices: Can help patients feel better overall Can help strength and flexibility

24. Treating Scoliosis Complementary practices: Should not replace traditional medical care Beware of practitioners offering cures

25. Treating Scoliosis Observation Back brace Surgery

26. Treating Scoliosis: Observation Curves of <20 degrees in growing children Curves of <40 degrees in older patients

27. Treating Scoliosis: Observation Ongoing x-rays are taken to measure the curve and determine whether it is changing

28. Treating Scoliosis: Bracing Does not correct curve only prevents worsening For patients with 20-40 degree curves

29. Treating Scoliosis: Bracing Selected for specific patient and condition Milwaukee brace (Cervico- Thoraco-Lumbo-Sacral-Orthosis) Boston brace (Thoraco-Lumbo- Sacral-Orthosis or TLSO) Charleston bending brace

30. Treating Scoliosis: Bracing Must be worn for certain number of hours every day ALWAYS follow orthopaedic surgeons instructions

31. Treating Scoliosis: Bracing Time off from brace can be used for sports or similar activities Brace should be worn every day until child stops growing

32. Treating Scoliosis: Surgery May be recommended for children with curve of >45 degrees If patient is done growing, may be recommended if curve is >50 degrees

33. Treating Scoliosis: Surgery Implants and bone grafts straighten and fuse the spine Surgery is the only treatment that will straighten the spine

34. Treating Scoliosis: Surgery Potential risks include: Nerve/spinal cord injury Healing problems Hardware problems

35. Treating Scoliosis: Surgery Walk without brace: 2-3 days Discharge from hospital: <7 days Return to sports: 6-9 months

36. Living With Scoliosis: Nutrition Eat a healthy diet, with 1,000 i.u. of vitamin D and 1,300 mg of calcium Eat calcium-rich foods

37. Living With Scoliosis: Nutrition Maintain a healthy body weight Absolutely NO SMOKING

38. Living With Scoliosis: Exercise Can help maintain strength and flexibility Can help minimize discomfort and loss of function

39. Living With Scoliosis: Exercise Aerobic sports recommended Focus on flexibility and core strength High-impact sports may be restricted

40. Living With Scoliosis: Exercise Exercise cannot correct scoliosis Avoid any practitioner who makes such claims

41. Living With Scoliosis: Exercise Consult with your orthopaedic surgeon before beginning any exercise program

42. Living With Scoliosis Curving often slows or stops in adulthood Most normal activities are safe Pregnancy and childbirth usually safe Follow up with orthopaedic surgeon

43. Living With Scoliosis Every patient and every case is different Treatment is customized to your needs Ask question, stay informed Partner with your orthopaedic surgeon

44. American Academy of Orthopaedic Surgeons 6300 North River Road Rosemont, IL 60018 orthoinfo.org Pediatric Orthopaedic Society of North America posna.org Scoliosis Research Society srs.org Resources

45. What are your questions and concerns? Get the Facts about Scoliosis

46. Thank you for participating today Remember, your orthopaedic surgeon can help get you back in the game