Scoliosis Part 4: X-ray Findings and Treatment
X-ray Findings
X-rays taken to exam scoliosis are specifically taken from the front-to-back or back to front view of the middle and low back. In this position we are able to evaluate the spine for normal versus abnormal curvatures. In this normal x-ray, the spine should be straight and look symmetrical from both sides. In this x-ray diagnosed as scoliosis, there is an “S” shaped curve in the spine.
In evaluating an x-ray for scoliosis, the Cobb Method is the standard measurement performed. The result of the Cobb method is a degree of angulation; the higher the angulation, the more severe the scoliosis. A Cobb angle of 0-5 degrees is considered normal. From 5-10 degrees is considered abnormal from four to twenty years old (before the last growth spurts). Over 10 degrees is considered abnormal for all ages. As patients are treated for scoliosis, new x-rays are taken to show improvement.
Treatment
There are 4 types of treatment available to correct scoliosis (in intensive order) are exercises/stretching, chiropractic care, bracing, and surgery. The treatment performed is usually correlated with the severity of the scoliosis and age of the patient. During rapid growth periods (10-20 years old) patients should be monitored with examinations and radiographs every 3 to 4 months when a scoliosis is more than 5 degrees.
Exercises and Stretching has not been shown to decrease scoliosis, but is used to improve muscle tone, flexibility and balance; complementing chiropractic care or bracing. Chiropractic is most effective when the Cobb angle is less than 20 degrees and the patient is not skeletally mature (under 20 years old). Realignment of the spine by CHIROPRACTIC, is THE ONLY NON-SURGICAL TREATMENT EFFECTIVE IN CORRECTING SCOLIOSIS.
Between 20 and 40 degrees, bracing is usually indicated to prevent further progression. Previous braces, such as the Milwaukee brace, limit a child’s motion. Current braces allow free range of motion and seem to provide better results in stopping progression of scoliosis. More than 40 degrees, scoliosis patients become candidates for surgery when organs become compromised. For example, as the spine continues to bend to one side, a person’s breathing may be difficult as the lungs are pushed against other organs.
Spinal Surgery is usually last resort in scoliosis patients because the success rate is low. Meaning, pain and other symptoms may continue and other surgeries maybe needed as the child continues to grow. The most common surgeries performed for scoliosis are Harrington Rods and the Dwyer Procedure to stabilize the spine. Post-operative radiographs are used to assess the correction of the Cobb angle and chance of infection. Future radiographs should minimally stop scoliosis progression and evaluate degenerative changes in the spinal bones and disc that may require future surgeries.
Future Monitoring
After any form of treatment for scoliosis, follow-up radiographs are taken at 3 to 4 month intervals and during growth phases. Failure to perform these can lead to long-term complications and deformity.
Author’s Note
In our current national economic crisis, scoliosis awareness is absent in our schools and communities. Parents need to educate themselves and have their children checked annually to prevent permanent physical complications as our children go through the adolescent years.
Contact Euclid Chiropractic Clinic for further information at:
60 E. Foothill Blvd
Upland, CA 91784
909-981-5666
www.euclidchiropracticinc.com
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X-rays taken to exam scoliosis are specifically taken from the front-to-back or back to front view of the middle and low back. In this position we are able to evaluate the spine for normal versus abnormal curvatures. In this normal x-ray, the spine should be straight and look symmetrical from both sides. In this x-ray diagnosed as scoliosis, there is an “S” shaped curve in the spine.
In evaluating an x-ray for scoliosis, the Cobb Method is the standard measurement performed. The result of the Cobb method is a degree of angulation; the higher the angulation, the more severe the scoliosis. A Cobb angle of 0-5 degrees is considered normal. From 5-10 degrees is considered abnormal from four to twenty years old (before the last growth spurts). Over 10 degrees is considered abnormal for all ages. As patients are treated for scoliosis, new x-rays are taken to show improvement.
Treatment
There are 4 types of treatment available to correct scoliosis (in intensive order) are exercises/stretching, chiropractic care, bracing, and surgery. The treatment performed is usually correlated with the severity of the scoliosis and age of the patient. During rapid growth periods (10-20 years old) patients should be monitored with examinations and radiographs every 3 to 4 months when a scoliosis is more than 5 degrees.
Exercises and Stretching has not been shown to decrease scoliosis, but is used to improve muscle tone, flexibility and balance; complementing chiropractic care or bracing. Chiropractic is most effective when the Cobb angle is less than 20 degrees and the patient is not skeletally mature (under 20 years old). Realignment of the spine by CHIROPRACTIC, is THE ONLY NON-SURGICAL TREATMENT EFFECTIVE IN CORRECTING SCOLIOSIS.
Between 20 and 40 degrees, bracing is usually indicated to prevent further progression. Previous braces, such as the Milwaukee brace, limit a child’s motion. Current braces allow free range of motion and seem to provide better results in stopping progression of scoliosis. More than 40 degrees, scoliosis patients become candidates for surgery when organs become compromised. For example, as the spine continues to bend to one side, a person’s breathing may be difficult as the lungs are pushed against other organs.
Spinal Surgery is usually last resort in scoliosis patients because the success rate is low. Meaning, pain and other symptoms may continue and other surgeries maybe needed as the child continues to grow. The most common surgeries performed for scoliosis are Harrington Rods and the Dwyer Procedure to stabilize the spine. Post-operative radiographs are used to assess the correction of the Cobb angle and chance of infection. Future radiographs should minimally stop scoliosis progression and evaluate degenerative changes in the spinal bones and disc that may require future surgeries.
Future Monitoring
After any form of treatment for scoliosis, follow-up radiographs are taken at 3 to 4 month intervals and during growth phases. Failure to perform these can lead to long-term complications and deformity.
Author’s Note
In our current national economic crisis, scoliosis awareness is absent in our schools and communities. Parents need to educate themselves and have their children checked annually to prevent permanent physical complications as our children go through the adolescent years.
Contact Euclid Chiropractic Clinic for further information at:
60 E. Foothill Blvd
Upland, CA 91784
909-981-5666
www.euclidchiropracticinc.com
Great series overall! I a Chiropractor also, and enjoyed your summary on Scoliosis. I hope people understand the permanent damage they can prevent with their children by getting them checked early.
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