Scoliosis Screening
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Background 
 
Scoliosis (curvature of the spine) is a condition in which the spine curves from one side to the other.  Scoliosis occurs in about 2 percent of the population.  It is more common in girls than boys.  Consult your doctor if yoususpect your child has scoliosis.  Thte doctor may suggest that you to take your child to an orthopedist (a surgeon specializing in deformities and diseases of the bones and joints).
 
There are two types of scoliosis - functional and structural.  Functional scoliosis may be caused by poor posture, a short leg, or muscle spasm. It does not result in any bone changes. Functional curves are flexible and disappear when the child lies down, Functional scoliosis can be treated by correcting posture, by fitting the child with special corrective devices such as a built-up shoe, or by drugs to relax muscles. 
 
Structural scoliosis is a spinal deformity that begins in childhood and usually results in permanent bone changes.  Some cases may be caused by spinal deformity that was present at birth or by a disease that deforms the bones of the spine during growth.  However, doctors do not know what caused 80 percent of all cases of structural scoliosis.
 
Although structural coliosis is rarely painful, it causes deformity.  A structural curve, unlike a functional curve, does not  disappear when the child lies down. Frequently  one hip or one shoulder appears higher than the other.  The chest appears of-center in relation to the pelvis.  The back of the ribs bend out, pushing out the shoulder blade.  When the child bends forward (Adams Forward Bend Test)  a hump appears on one side of the upper back.  The deformity caused by structural scoliosis frequently worsens as the child grows.  Early diagnosis and treatment are important.  
 
Treatment of structural scoliosis depends on the severity of the curve.  An orthopedist may prescribe spinal muscle exercises, heel lift to straighten the pelvis, casts or braces or surgery.  Structural scoliosis can rarely be completely curved but early treatment can lessen its effects. 
 
 
Who do we screen?
 
The school nurse does the scoliosis screening in 6th grade.  Scoliosis usually becomes noticeable during the adolescent growth spurt so screening is done in grade six.  It is repeated at the Junior High level in 7th grade.
 
How does the nurse perform the screening?
Scoliosis screenings take  place during PE.  This is an observation only assessment.  The students stand facing the nurse and the nurse observes for any asymmetry in shoulders or hips as she walks in front of the class and behind the class.  Second the students bend forward at the waist.  The nurse observes for uneven scapula, uneven hips, curvature of the spine and spinal humps.  If any of the above are seen a second screening is done.
 
At the second screening the nurse calls the students from each class and repeats the same procedure.  However when the Adams Forward Bend Test is done, she may use a scoliometer to measure the unevenness of the spine.  If significant asymmetry is seen she will send a referral home for further evaluation by your family physician.
 
 
Opting out
 
Scoliosis screenings usually take place during the spring quarter.   If you wish to opt out of this screening please notify the nurse in writing before the screening takes place.   
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