Scoliosis with all hospital in korea

Scoliosis with all hospital in korea

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■ Outline:

Adult scoliosis can be thought of as two cases of scoliosis that persisted before the end of the growth period and after the adult.

There are only one symptom of adult scoliosis and it is common to have various symptoms at the same time, mainly pain, anxiety about progress of scoliosis, cosmetic problem, cardiopulmonary function disorder and neurological disorder.

The diagnosis of adult scoliosis is made by examining the patient and verifying whether the vertebrae are scoliosis, whether the vertebra is bent forward or backward, then anteroposterior and lateral radiographs are performed, and flexion flexibility is checked by lateral and lateral flexion radiography. Specialized tests include spinal angiography, computed tomography, magnetic resonance imaging, discography, and bone scan.

Treatment is usually conservative, but severe cases may require surgical treatment.

■ Synonyms:

Adult scoliosis, Adult scoliosis

■ Definitions:

Adult scoliosis refers to scoliosis after complete integration of the pelvic ridge is confirmed and age is over 18 and physiological growth is terminated.

Adult scoliosis can be thought of as either scoliosis that continued before the end of the growth period or scoliosis that occurred after becoming an adult.

■ Symptom:

The main appeal of adult scoliosis patients is pain, anxiety about progression of scoliosis, cosmetic problems, cardiopulmonary disorders, and neurological disorders.

Causes of pain associated with adult scoliosis are caused by muscle fatigue and tension, pathological changes in the disc, nerve root compression and pathological changes in the posterior spine.

Decreased cardiopulmonary function may be accompanied by severe thoracic curve.

■ Causes / Pathophysiology:

Adult scoliosis can be categorized as either persistent scoliosis (usually pubertal idiopathic scoliosis) prior to the end of the growth period or adult incidence.

The causes of scoliosis after adulthood are due to metabolic bone diseases such as osteoporosis, degenerative changes, and after decompression of vertebral stenosis over multiple nodes. different.

Generally, the curvature of 30 degrees or less after the end of bone growth does not proceed regardless of the shape of the curvature, and the progression of the curvature above 30 degrees is related to the rotation of the vertebra. The most progressive curve is a thoracic curve of more than 50 degrees after growth, which increases to around 1 degree per year.

■ Diagnosis:

After the patient is examined, antero-posterior and lateral radiography including the entire spine from the neck is essential.

Flexibility of the curvature should be checked by lateral flexion photography, and sometimes radiography after traction.

In patients with neurological symptoms, vertebral angiography, computed tomography, and magnetic resonance imaging are necessary, and sometimes discography and bone scan are sometimes necessary.

Patients who complain of respiratory symptoms with other tests require a pulmonary function test and an arterial blood gas analysis. Congenital abnormalities of the vertebral body require a kidney and heart test.

■ Progress / Prognosis:

Curvature of less than 30 degrees does not proceed in adult scoliosis.

In the case of a thoracic curve of more than 50 degrees, it can progress well, and in this case it progresses to about 1 degree per year.

Back pain is a common symptom of adult scoliosis, occurring in about 70% of patients, and the frequency of pain increases with age and curvature.

Decreases in cardiopulmonary function are often accompanied by severe thoracic curve. In most cases, the curvature of the patient is less flexible than the idiopathic scoliosis of puberty, is firm, and has a large angle of curvature. Therefore, it does not respond well to conservative treatment and surgical treatment is not easy due to poor systemic condition and osteoporosis.

■ Complications:

In addition to severe spinal deformities, neurological abnormalities such as decreased cardiopulmonary function, sensory dysfunction due to vertebral stenosis, protrusion of the chest area due to rib deformity, decrease in height due to progression of the curve, and pain may occur.

■ Treatment:

Adult scoliosis is in principle the same as in the treatment of puberty scoliosis. Indications for treatment include increased deformity, pain, gradual deterioration of cardiorespiratory function, and cosmetic problems. Symptoms of nerve roots or spinal stenosis caused by degenerative changes of the joints of the spine are also treated.

Nonsurgical treatments include analgesics, heat therapy, nonsteroidal anti-inflammatory drugs, physical therapy, exercise therapy, etc., and the use of orthoses is aimed at alleviating pain.

Surgical treatments include those with over 50 degrees of curvature, severe chest or lumbar flexion, neurological symptoms, apparently ugly, and likely to progress.

■ Prevention:

If the progression of the curvature is uncertain or doubtful, if the patient does not have an appeal for deformation, if there is no pain, or if there is no deterioration of the pulmonary function, it is advisable to observe the periodic radiographs at intervals of one year.

In the treatment of adult scoliosis, several non-surgical treatments can improve the patient's overall life function, and in particular smoking cessation is essential to improve cardiorespiratory function.

For postmenopausal women, osteoporosis is a decisive factor in the progression of scoliosis, so you should be careful to prevent osteoporosis after menopause.

■ To the doctor:

If you have severe spinal deformity, pain in the lumbar spine, sensory or motor dysfunction, or severe spinal deformity as well as cardiopulmonary deterioration, you should seek a spine specialist as soon as possible.