Brief presentation on Scoliosis used by nursing students to present in class.

1. Scoliosis

2. What is Scoliosis?
• A medical condition characterized
by an abnormal, sideways
curvature of the spine.
• Often resembles an "S" or "C"
shape.
• More than just a curve involves
rotation of the vertebrae as well.
• Can affect any part of the spine
(thoracic, lumbar, or both).

3. Types of Scoliosis
• Idiopathic Scoliosis: Most common type
(80-85%), cause unknown.
• Infantile (0-3 years)
• Juvenile (4-9 years)
• Adolescent (10-18 years) - most
common idiopathic type
• Congenital Scoliosis: Present at birth, due
to vertebral malformations.
• Neuromuscular Scoliosis: Develops as a
secondary symptom of other conditions
affecting nerves and muscles (e.g., cerebral
palsy, muscular dystrophy, spina bifida).
• Degenerative (Adult) Scoliosis: Develops
later in life due to disc degeneration and
arthritis.

4. Signs and Symptoms

5. Signs and
Symptoms
Visual Cues (Often subtle at first):
• Uneven shoulders (one shoulder blade higher than the other).
• One hip higher than the other.
• Uneven waistline.
• One side of the rib cage appearing more prominent (rib hump)
when bending forward.
• Head not centered directly over the pelvis.
• Body tilting to one side.
Other Symptoms:
• Back pain (especially in adults or with significant curves).
• Fatigue of the spine after prolonged sitting or standing.
• Difficulty breathing (in severe cases where the curve affects
lung capacity).
• Neurological symptoms (rare, but can occur if the spinal cord is
compressed, e.g., weakness, numbness, bowel/bladder
changes).

6. Laboratories/Diagnostics
Physical Examination:
• Adam's Forward Bend Test: Patient
bends forward at the waist, arms
hanging down, to check for a rib hump
or spinal asymmetry.
• Assessment of posture, leg length, and
range of motion.
Imaging Studies:
• X-rays (Standing AP/Lateral views):
• Primary diagnostic tool.
• Measures the Cobb Angle (gold
standard for measuring curve
magnitude).
• Evaluates spinal maturity (e.g., Risser
sign).

7. Cobb angle

8. Laboratories/Diagnostics
MRI (Magnetic Resonance Imaging):
• May be used to rule out underlying
neurological conditions or spinal cord
abnormalities, especially for atypical
curves, rapid progression, or
neurological symptoms.
CT Scan (Computed Tomography):
• Provides detailed bone imaging,
sometimes used for surgical planning.
Scoliometer
• A device used in screenings to measure
the trunk rotation.

9. Scoliometer

10. Anatomy and Physiology
Anatomy of the Spine
• Vertebrae: Individual bones that
make up the spinal column
(cervical, thoracic, lumbar,
sacrum, coccyx).
• Intervertebral Discs: Act as shock
absorbers between vertebrae.
• Spinal Cord: Housed within the
vertebral column, transmitting
nerve signals.
• Muscles and Ligaments: Support
and stabilize the spine.

11. Anatomy and Physiology
Normal Spinal Curvatures
• Cervical and Lumbar: Lordotic
(inward curve).
• Thoracic and Sacral: Kyphotic
(outward curve).

12. Anatomy and Physiology
• Physiology of Scoliosis: In
scoliosis, the normal curves are
distorted.
• The spine develops a lateral
curve and also rotates.
• This rotation can cause the
ribs to protrude, forming the
"rib hump."
• The abnormal
biomechanics can lead to
muscle imbalance and
strain.

13. Pathophysiology

14. Treatment/Management
• Goals of Treatment: Prevent
curve progression, improve
spinal alignment, manage pain,
optimize function, prevent
complications.

15. Treatment/Management
Bracing:
• For moderate curves (20−45∘) in
growing patients.
• Does not correct the curve but aims
to prevent further progression.
• Examples: Boston Brace, Milwaukee
Brace.
• Compliance is crucial for
effectiveness.

16. Treatment/Management
Physical Therapy/Exercise:
• Can help with pain management, core
strengthening, improving posture, and
flexibility.
• Specific scoliosis-specific exercises
(e.g., Schroth method) may be
beneficial for some patients.

17. Treatment/Management
Surgery (Spinal Fusion):
• For severe curves (>45−50∘) that are
progressive, especially in
adolescents.
• Involves joining vertebrae together
using rods, screws, and bone grafts to
straighten and stabilize the spine.
• Considered when non-surgical
treatments have failed or the curve is
too large.

18. Treatment/Management
Pain Management:
• Over-the-counter pain relievers
(NSAIDs).
• Heat/cold therapy.
• Massage.

19. Nursing Interventions
Assessment:
• Thorough physical assessment for signs of
scoliosis.
• Pain assessment (location, intensity,
aggravating/alleviating factors).
• Respiratory assessment (rate, effort, breath
sounds) for severe curves.
• Neurological assessment (sensation, motor
strength, reflexes).
• Psychosocial assessment (body image, self-
esteem, coping mechanisms).

20. Nursing Interventions
Education and Support:
• Educate patients and families about scoliosis,
treatment options, and prognosis.
• Provide clear instructions on brace wear and
care (if applicable).
• Discuss the importance of adherence to
physical therapy.
• Address concerns about body image,
especially in adolescents.
• Connect families with support groups or
resources.

21. Nursing Interventions
Pre- and Post-operative Care (if surgery is
planned): Pre-op:
• Patient education, psychological preparation,
baseline assessments.
Post-op:
• Pain management (opioids, NSAIDs, epidural
analgesia).
• Frequent neurological checks.
• Respiratory care (deep breathing, incentive
spirometry).
• Wound care.
• Ambulation and mobility assistance as per
surgeon's orders.
• Monitoring for complications (infection, nerve
damage, blood loss).

22. Nursing Interventions
Long-term Management:
• Reinforce the need for regular follow-up
appointments.
• Encourage maintaining a healthy lifestyle,
including regular exercise.
• Monitor for potential complications or
progression into adulthood.