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SCOLIOSIS

SCOLIOSIS. Three dimensional deformity involving rotation of the vertebral bodies Causes the rib cage to become misshapen Body develops a compensatory curve to maintain posture and balance Nonstructural scoliosis does not involve rotational or muscular deformity due to poor posture. Degrees.

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SCOLIOSIS

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  1. SCOLIOSIS • Three dimensional deformity involving rotation of the vertebral bodies • Causes the rib cage to become misshapen • Body develops a compensatory curve to maintain posture and balance • Nonstructural scoliosis does not involve rotational or muscular deformity due to poor posture

  2. Degrees • 10 to 20 a slight curve • More than 40% curve requires surgery • More than 80% compromises respiratory function and is considered severe

  3. Clinical Manifestations • Visible curve of the spine • A rib hump when bending forward • Asymmetric rib cage • Uneven shoulder or pelvic heights • Prominence of scapula or hip • Difference in space between arms and trunk when standing • Apparent leg-length discrepancy

  4. Diagnostic Evaluation • Routine scoliosis screening • Radiographic examination

  5. Management • Regular and periodic observation with radiographic evaluation • Bracing • Spinal fusion surgery • Body image – talk about diagnosis, treatment, and feeling about experience • Discuss activities – school or activities • Notify school nurse

  6. Bracing • Worn 18-23 hours a day • Wear 100% cotton, seamless T-shirt • Proper skin care • Clean inside/outside of brace daily • Notify HCP – numbness tingling of arms, leg, feet, cracks or breaks in brace, skin problems, respiratory problems

  7. SURGERY • Curvature > 45 degrees • Spinal fusion with internal instrumentation • Delayed as long as possible to allow maximum skeletal growth • Most common posterior fusion • Iliac bone graft can be used for the fusion

  8. Spinal Fusion • Neurovascular checks – 6 P’s • Log rolling every 2 hours • Pulmonary toileting • Wound care • Pain – PCA pump • Rule out complications – neurological status lower extremities, fluid status, bleeding, return of bowel function

  9. Discharge teaching • Wound care • Importance of well balanced diet • Activity restrictions (Orthoplast jacket) • Report to HCP – skin breakdown, wound infection, numbness/tingling extremities, difficulty breathing • Provide information about National Scoliosis Associations

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