Scoliosis

　　The majority of adolescents with scoliosis are suffering from idiopathic scoliosis. Idiopathic means the cause is unknown. Researchers do not know what causes idiopathic scoliosis. Genetics may be one of the causes. There are many other theories. It is still unclear whether these factors cause scoliosis or they are the result of scoliosis. Most researchers agree that more than one factor causes scoliosis.

　　Below are some factors that some researchers believe may lead to scoliosis.

　　Genetics

　　Scoliosis often appears in families. One study points out that about one-tenth of patients with scoliosis have a 'direct relative' with scoliosis. Direct relatives include parents, siblings, or children. In the same study, it was found that about 2% of patients with scoliosis have 'collateral relatives' with scoliosis. Collateral relatives include grandparents, grandchildren, aunts (aunts), uncles (uncles), nieces, nephews, or half-siblings with the same father or mother.

　　Growth issues

　　Adolescents grow rapidly during puberty, and scoliosis may worsen. In the early stages of puberty, around 8 to 9 years old, patients with scoliosis are generally taller than normal adolescents. When patients with scoliosis are 10 years old and older, their height is about the same as that of normal adolescents.

　　Patients with scoliosis have higher levels of growth hormone from the age of 7 to 12. After the age of 12, their levels of growth hormone are like those of normal adolescents.

　　Many children grow rapidly, but they do not develop scoliosis. This supports the view that more than one factor may lead to scoliosis.

　　Problems with connective tissue and muscles

　　Some researchers believe that defects in our connective tissue may lead to scoliosis. Our ligaments (the tissues that connect bones) and intervertebral discs of the spine are examples of connective tissue. Other researchers believe that these changes in connective tissue are caused by scoliosis.

　　Researchers have studied the muscles along the spine. They found that some of these muscles in patients with scoliosis are abnormal. However, they could not confirm whether they are the cause or the result of scoliosis.

　　Problems with the nervous system

　　Proprioception is the way we maintain our posture. We do this by using the points of force within our joints and muscles. Some researchers believe that the loss of proprioception can lead to muscle weakness on one side of the body. By extension, this can lead to scoliosis.

　　The vestibular system provides us with a sense of balance. The tubes in the inner ear control our sense of balance. One study shows that patients with scoliosis have problems with their vestibular balance.

　　Similarly, we do not know whether the abnormality is the cause or the result of scoliosis.

　　Melatonin levels

　　Melatonin is a hormone secreted by glands in the brain. It manages the 24-hour biological clock known as our circadian rhythm. This 24-hour clock tells us to do different things at different times of the day, like sleeping at night when it gets dark.

　　Melatonin has a relationship opposite to that of growth hormone. When growth hormone is at a high level, melatonin is at a low level. Researchers believe that if patients with scoliosis have higher than normal levels of growth hormone, they may also have lower than normal levels of melatonin.

　　Some studies have shown that patients with scoliosis have lower levels of melatonin within 24 hours. However, researchers believe that melatonin accelerates the curvature of the spine more than the causes of scoliosis.

　　Many animal surgery studies have shown that melatonin can promote the development of scoliosis. Remember, there is still a long way to go from animal research to human research.

　　Scoliosis can lead to many complications, including headaches, neck pain, difficulty turning the head, numbness and tingling in the arms, and upper back pain. After spinal correction treatment, these symptoms can be relieved or improved. Many patients may also experience scoliosis, and the efficacy is best for children, while the efficacy for adults depends on the degree of permanent joint damage of the spine and the number and duration of treatment.

1. Razorback deformity.
2. Unequal height of the shoulders and the anterior superior iliac spines on both sides, and an asymmetric chest.
2. Symptoms of organ compression, the most important of which is compression of the circulatory system, heart displacement, limited heart function, and accelerated heartbeat. Next is reduced lung capacity and accelerated breathing. In addition, the digestive system may be compressed, leading to poor digestion and lack of appetite. The nervous system may produce radicular pain and myelopathy.

　　Prevention of scoliosis

　　(i) Prevention and correction of scoliosis: correct bad habits and incorrect posture

　　1. Sleep on a hard bed.

　　The human spine is curved from the side, which is medically known as the 'physiological curve' or 'physiological bend'. When lying on a horizontal surface, the spine of the back and waist supports the body strongly, but if lying flat on a too soft bed for a long time, the body's own weight will change or disappear the 'physiological curve' of the spine. That is, the spine becomes straight (from the side), resulting in discomfort or pain. Since children's spines are very flexible and easily form, children, especially those in the growth and puberty stages, and overweight children, should choose a hard bed to maintain the physiological curve of the spine.

　　2. For infants and young children, the choice of pillow should be guided by a professional physician, and it is ideal and suitable. Children's pillows should be low and soft. When sleeping, it is best to let the child's entire shoulder and back rest on the pillow to reduce the strain on the neck. It is not advisable for children to sleep on their stomachs for a long time. Although they may love this posture. You can tell them: 'Frogs cannot become princes.'

　　(ii) While walking:

　　1. Do not choose shoes that are too big for children, as this is not a good way to save money, because children's feet grow much faster than imagined. Shoes that are too big will make it difficult for children to walk with coordination, and if this continues for a long time, it will increase the working pressure on the spine, leading to pain.

　　2. Do not choose excessively hard and thick-soled shoes for children. This will make it difficult for them to feel the ground better when walking, thereby increasing the load on the spine. Do not let girls wear long boots that restrict ankle movement, even high-heeled or pointed-toe leather shoes. This will increase the burden on the spine, especially the waist. Beauty should be based on health.

　　3. Try to avoid walking barefoot. Especially in summer and warm seasons, foot coldness will promote and exacerbate the pain in the lower limbs and lumbar spine.

　　(Three) when going to school:

　　1. Avoid carrying a backpack on one shoulder, although it looks cool. Pay attention, maybe when you grow up, you will become uneven shoulders, or even a patient with scoliosis.

　　2. When taking a bus, it is better not to sleep for a long time on the front chair backrest. This is not only dangerous but also very detrimental to the health of the spine.

　　3. The chairs in the classroom are never suitable for every child. Therefore, we suggest that children sit in the front third or half of the chair seat, and try to keep the upper body straight, do not maintain a curved back and waist posture, to reduce the pressure on the heart, lungs and waist. When listening to lectures and doing assignments, do not tilt your body to increase the lateral pressure on the spine of the back. Otherwise, your spine will not be as beautiful as your writing.

　　4. It's better not to sleep on the desk in the classroom, otherwise, both teachers and doctors will invite you to their office as a guest.

　　5. Extracurricular physical activities. Attention should be paid to avoid jumping down from a height.

　　5. Avoid being撞击 by others. This horizontal horizontal force impact on the spine is very dangerous.

X-ray films can clearly determine the degree of curvature.

　　Measurement of curvature: (1) Cobb's method: the most commonly used, the angle formed by the perpendicular line from the superior margin of the upper end vertebra to the inferior margin of the lower end vertebra is the Cobb angle. If the superior and inferior margins of the end vertebra are unclear, you can take the line connecting the superior and inferior margins of the vertebral pedicle, and then take the angle formed by the perpendicular line as the Cobb angle. (2) Ferguson method: rarely used, sometimes used to measure mild lateral curvature. Find the midpoint of the vertebral bodies of the end vertebra and the apex vertebra, and then draw two lines from the midpoint of the apex vertebra to the midpoint of the upper and lower end vertebrae respectively, and the angle formed by the intersection of the two lines is the lateral curvature angle.

　　Measurement of vertebral rotation degree: Nash and Mod divided it into 5 degrees according to the position of the vertebral pedicle on the anteroposterior X-ray. 0 degree: the vertebral pedicle is symmetrical; I degree: the convex side vertebral pedicle moves towards the midline but does not exceed the first grid, and the concave side vertebral pedicle becomes smaller; II degree: the convex side vertebral pedicle has moved to the second grid, and the concave side vertebral pedicle disappears; III degree: the convex side vertebral pedicle moves to the center, and the concave side vertebral pedicle disappears; IV degree: the convex side vertebral pedicle crosses the center, close to the concave side.

　　Regular dietary intake should be reasonable, and rationally develop the habit of coarse and fine grain pairing, meat and vegetable pairing, and mixed eating of various vegetables (green, yellow and melon and eggplant types). Secondly, diet should have a focus, especially during the period before surgery, and pay more attention to diet, and appropriately supplement protein. The amount of protein per day can reach about 100-150 grams (2-3 liang), and try to choose foods rich in high-quality protein. Eat in small portions and multiple meals, with 6 meals per day. You can increase 1 serving of whole milk or skim milk, 1-2 servings of yogurt, 1 egg, an appropriate amount of soybean powder or 1 serving of tofu, and an appropriate amount of animal liver or kidney on top of your original diet. On the night before the surgery (if there is no diabetes), you can eat more fat-free candies.

　　Egg and Date Soup: 2 eggs, 10 dates, an appropriate amount of brown sugar. Boil water in a pot, add eggs and cook, then add dates and brown sugar, and simmer for 20 minutes. It has the effects of tonifying the middle, invigorating the Qi, and nourishing the blood.

　　Goose and Goji Soup: One goose, 30 grams of goji, a little salt. Remove the feathers and internal organs of the goose, wash it clean, put it in a pot with water and goji, cook until done, add a little salt when it's done. Eat the meat and drink the soup, twice a day. It has the effects of invigorating the body, nourishing the blood, and treating deficiency. It is suitable for people with physical weakness, post-sickness deficiency, fatigue, spontaneous sweating, and other symptoms.

　　Non-surgical treatment includes physical therapy, physical therapy, surface electrical stimulation, plaster and brace. But the most important and reliable method is brace treatment.

　　Indications for brace treatment:

　　(1) Mild scoliosis between 20-40 degrees, scoliosis exceeding 40 degrees is not suitable for brace treatment.

　　(2) Children with immature bone structures are suitable for brace treatment.

　　(3) When two structural curvatures reach 50 degrees or a single curvature exceeds 45 degrees, brace treatment is not suitable

　　(4) Scoliosis with anterior chest convexity is not suitable for brace treatment.

　　(5) Segmental long curvature, the therapeutic effect of the brace is good, the lumbar or thoracolumbar scoliosis with good elasticity below 40 degrees.

　　(7) Patients and parents who do not cooperate are not suitable for brace treatment

　　Brace Wear

　　When wearing it for the first time, it should be worn for 23 hours a day, with 1 hour for physical therapy, breathing exercises, and other activities. If the cooperation of the patient and the family cannot be obtained, it should be worn for at least 16 hours a day. If the Cobb angle can be reduced by 50% after wearing the brace, it is expected to achieve a good therapeutic effect. After one year of treatment, if the scoliosis can be reduced by 50%, the wearing time can be gradually reduced, and it can only be worn at night as the Risser increases. If the scoliosis starts to increase by more than 5 degrees again, the wearing time needs to be increased again.