From time to time, the National Scoliosis Foundation receives letters from parents about kyphosis. To find out more about this spinal deformity, our Medical Update editor, Nancy Schommer, interviewed Dr. Howard King, Clinical Associate Professor of Orthopaedic surgery, University of Washington, and Northwest Spine and Pediatric Orthopaedic Surgeons Seattle, Washington. What follows are excerpts from that interview.
“During a recent school screening, it was determined that your son/daughter may have a condition called scoliosis, or curvature of the spine. Please consult your physician for further information and available treatment options.”
For most parents, this news can be both alarming and confusing, especially when a child appears to be both healthy and active at the time of diagnosis. Clearly, routine spinal screenings have done much to increase the population’s awareness of scoliosis in general, but serious questions rarely arise until a parent discovers that his or her child may have the disorder.
From time to time, NSF receives inquiries about a condition called flat back syndrome. To find out more about it, Nancy Schommer recently interviewed Michael LaGrone, MD, a scoliosis specialist who has a private practice in Amarillo, Texas. Dr. LaGrone is a member of the Scoliosis Research Society and a medical advisor to the NSF. He is also a member of the clinical faculty of the Texas Tech University Health Science Center.
Every year, the National Scoliosis Foundation receives queries about rib thoracoplasty, a surgical technique sometimes used to help patients with scoliosis who also suffer from a “rib hump”. To find out more about the procedure, NSF asked Dr. Serena S. Hu, Assistant Professor, Department of Orthopaedic Surgery at the University of California, to respond to a number of questions. What follows are excerpts of her responses, which have been edited by Nancy Schommer, author of Stopping Scoliosis.
Because the National Scoliosis Foundation receives constant inquiries from individuals asking whether pain is a symptom of idiopathic scoliosis, we interviewed Dr. Robert Winter, internationally know for work in surgical and non-surgical treatment of spine deformity. Dr. Winter is the author of numerous textbooks, papers, and chapters of surgical textbooks. He is a frequent speaker at national and international orthopaedics conferences. He is also a founding member and past president of the Scoliosis Research Society, President of the Minnesota Spine Center, Chief of Spine Service at Gillette Children’s Hospital, and Clinical Professor of Orthopaedic Surgery at the University of Minnesota.
As many of our readers know, the Scoliosis Research Society, the American Academy of Orthopaedic Surgeons, and over 23 states suggest or require school screening for abnormal spinal curvatures. In September of 1992, Dr. William P. Bunnell, Professor and Chairperson, Loma Linda University Medical Center, presented his paper, “Outcome of Spinal Screening” to members of the Scoliosis Research Society; his findings will also be published in an upcoming issue of Spine. Dr. Bunnell is a developer of the Scoliometer, a hand-held device used in assisting spinal screening programs across the country. What follows are excerpts from an interview that the NSF conducted with Dr. Bunnell about his study:
On January 5, 1990, at our request Ann Landers reprinted a 1983 letter from NSF’s Vice President, Kenneth Love. As a result of that letter appearing in her syndicated column, we’ve received numerous letters and phone calls concerning a variety of subjects, including infantile, juvenile and adolescent idiopathic scoliosis, not to mention kyphosis and kypho-scoliosis. In order to clarify these and other terms, we interviewed Dr. John B. Emans, of Children’s Hospital Medical Center in Boston, Massachusetts. We thank him for helping us “get the terms straight.”
For the person anticipating scoliosis surgery, it is confusing and sometimes troubling to learn of the wide variety of instrumentation systems that are in use today. Why, the patient wonders, are there so many? How are they different? Which one is best? That last question is the easiest to answer. The fact is there is no one “best” instrumentation for every patient or for every physician. In planning the surgery, the physician takes a number of factors into account: the location and magnitude of the curve, the degree of rotation, the extent of deformity of the individual vertebrae, the rigidity or flexibility of the spine, the density of the bone, and the size of the patient. In addition, the physician may have a personal preference and skill for working with one instrumentation or another.
Many adults with scoliosis, including those with prior corrective surgery, are curious about the risks and benefits of exercises and sports participation. In our experiences, most adults with scoliosis have never held discussions with medical professionals about these issues. Research based information about therapeutic or recreational exercise for adults with scoliosis is lacking. The advice expressed in this article will therefore reflect experiences described to us by our patients with scoliosis, and our recommendations to these patients.
Adolescents with scoliosis and their families have questions concerning exercise. These questions are usually about two general areas:
- Can exercise correct or stop the progression of the scoliosis curve?
- Are recreational exercise and sports participation advised?
In this article, we will present some of the advantages and limitations of exercise for adolescents with scoliosis. Adults with scoliosis, including those with corrective surgeries, often also seek advice about exercises, especially if they begin experiencing discomfort and stiffness in their backs. Therapeutic and recreational exercise for adults will be presented in a future article.