Noemi Jimenez Topic: Scoliosis
General Purpose: To inform
Specific Purpose: To inform the audience about the deformity, scoliosis
Central idea: Today, I would like to share with you what scoliosis is, how one gets scoliosis, and what are the options one has on preventing scoliosis from getting worse.
Preview of speech: Scoliosis is a rapidly growing deformity in the United Stated, 3 out of 4 children in an elementary school sized classroom have scoliosis and only 1 will know that they have it. To better understand scoliosis, today I will tell you what scoliosis is, how someone gets scoliosis, and what are the options that someone with scoliosis has. Link: First, What is Scoliosis?
I. Scoliosis is a lateral (side to side or front to back curvature of the spine)
A. The spine is made of twenty- four flexible bony elements called vertebrates and they begin from the cervical down to the Coccygeal or tailbone.
- Orthopedists determine the degree of a scoliotic curve by measuring with the Cobb angle.
- Lines are drawn on the x-ray of the spine parallel to the highest and lowest vertebrate in the curve.
- Then, a line is drawn vertical to those two lines and the angle where they intersect is the degree of the curve.
- If the perpendicular lines would be parallel verticals and the Cobb angle would be zero, then the spine is straight.
B. Although scoliosis is a serious matter depending on the degree of the curvature, it doesn’t always affect people who have it, many lead normal lives without ever knowing.
- According to the studies made by Doctor Michael Neuwirth, director of the Spine Institute in New York City, only about 10% of people who have scoliosis actually suffer.
C. Orthopedists have classified scoliosis into four different types according to what causes the deformity.
- The first and most common is idiopathic scoliosis (80-85% of all cases); this means that the doctors have not found the cause. This type of scoliosis is classified into age groups; the infantile, juvenile, adolescent, and the adult. In these cases as the child develops and begins to go through growth spurts the doctor may notice something abnormal about the spines development. Idiopathic scoliosis runs in the family, so if you have it chances are your children will also have it.
- The second type is congenital scoliosis (15 to 20%). Congenital scoliosis is present at birth from birth defects. The spine is lop-sided which causes problems such as kidney dysfunctions, urinary tract abnormalities, or congenital heart defects.
- The third type is neuromuscular scoliosis which is caused by neuromuscular diseases that create insufficient functioning of a person’s muscles or nerves around the spine. In the 1950s the major cause of neuromuscular scoliosis was polio; today it is most likely cerebral palsy. This is because cerebral palsy causes the body to progressively waste its own muscles.
- The last type is degenerative scoliosis which is formed during an adult’s life as a consequence of the discs degenerating or loss of support in the spinal column. Link: Now that I have defined scoliosis, I will explain who can get scoliosis.
II. Truth is that anyone can get scoliosis. Not everyone who has scoliosis has symptoms or complaint of back pain. Not even those with an 80 degree curvature.
A. Thirty states require that students get screened at school.
- These screenings are usually done in the 6th and 7th grade when a child starts going through puberty, so it will help with early detection.
- The reason why not every state does this is because of the costs. Not all schools can afford to pay for a screening program.
B. According to the “Scoliosis Research Society of the American Academy of Orthopedic Surgeons”, only 10% of adolescents have a serious degree of scoliosis. Less than that 10% have scoliosis that requires any type of treatment.
- Statistically a young girl’s spine curvature tends to increase over time more rapidly and significantly than a young boy’s spine curves.
- As stated in “the Scoliosis Sourcebook” by Doctors Michael Neuwirth and Kevin Osborn, researchers have not been able to determine which one of the many differences between the males and females contribute to the higher incidences and faster rate of progression of scoliosis curves in females. They believe hormonal differences may be a factor. Link: Finally, I would like to tell you about the options a person with scoliosis has.
III. Before I explain what the options are I would like tell you what are some things to look for when checking yourself and/or your children for scoliosis.
A. One hip may look higher than the other, one shoulder blade may look bigger, the neckline is uneven, a curve in the spine in the most obvious, or any other improper alignments can be a clue.
- Doing the Adams forward bend test can help to check for a rib hump.
B. If detected early, before the child’s skeletal structure has matured, a back brace (orthopedic brace) is the first and most recommended option by orthopedists.
- A back brace is used to attempt to halt further curve progression. Some patients’ curvature degree may not change, but in a few cases it can get smaller. Bracing is recommended to patients with a curvature of 25 or greater degree.
- The first kind of brace and most common is called the Boston or TLSO (Thoraco-Lumbo-Sacral-Orthosis) brace. The brace is fitted to the patient’s body and custom molded with plastic. It is worn under clothing and it is typically not noticed. Worn 23 hours a day.
- The second kind of brace is the Milwaukee brace; it is similar to the body of the TLSO brace. It contains a neck ring that is held in place by vertical bars and is attached to the brace. Used for curves closer to the shoulder blades.
- The last kind is the Charleston “Nighttime” brace; it is worn only while the patient is sleeping. The brace is molded while the patient is bending to the side, by doing this it applies more pressure bending the child away from the curve.
C. Even if scoliosis is detected early no one will know how the curvature will progress, so it is important to check regularly so that it will not get worse. If bracing is not an option the other option would be surgery.
- 1. The curve would have to be more than 40 or 45 degrees and demonstrate continued progression, with or without serve back pain.
- 2. Although the Harrington- rod surgery is the best- known surgical treatment, it is no longer commonly used.
- 3. When the patient undergoes spinal- fusion the surgeon anchors the hard-ware to the spine through the uses of screws, hooks, or wires. By doing this the surgeon corrects the curvature and allows flexibility in the spine. Link: As you can see those were the options one with scoliosis has.
Summary Statement: I hope that you have learned what scoliosis is, who can get scoliosis, and what the options for you and/or your children are.