Beware of scoliosis, stand like a pine tree and sit like a bell

Author: Jia Xiaoyi Children's Hospital Affiliated to Zhejiang University School of Medicine

Yu Yonglin, deputy chief physician, Children's Hospital, Zhejiang University School of Medicine

Reviewer: Li Haifeng, Chief Physician, Children's Hospital Affiliated to Zhejiang University School of Medicine

The spine is very important in the body, supporting the trunk, protecting the internal organs and allowing movement. The spine is located in the middle of the back, with the upper end connected to the skull and the lower end reaching the tip of the coccyx. It is the real "weight-bearing column" of the body. However, due to various reasons, the spine may bend, which not only leads to appearance deformity, but also affects the body's movement function.

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So next, let me take you to understand scoliosis!

Scoliosis is usually divided into idiopathic scoliosis and other types of scoliosis. Idiopathic scoliosis is the most common type of scoliosis in children and adolescents. Its occurrence may be related to genetics, nerves, hormones, bones, muscles and posture habits, but the specific cause is unknown and may be caused by multiple factors. Other types of scoliosis include congenital scoliosis, neuromuscular scoliosis and syndromic scoliosis.

Adolescent idiopathic scoliosis (AIS) has become the third largest disease that endangers the health of children and adolescents in my country after obesity and myopia. The global incidence rate is 2% to 3%. AIS is more common in adolescents aged 10 to 18, especially women, and progresses rapidly throughout puberty. According to the previous epidemiological survey data of the Spine Disease Prevention and Control Committee of the Chinese Association of Preventive Medicine, it is estimated that the number of AIS students in primary and secondary schools in my country has exceeded 5 million, and is still increasing at a rate of about 300,000 per year. Scoliosis not only affects the beauty of the body, but if it continues to progress, it will also cause back pain, nerve damage, indigestion or limb sensory disorders, as well as indigestion and lack of appetite due to affected gastrointestinal function. If a child's thoracic scoliosis causes the chest to be squeezed, twisted and deformed, the chest cavity becomes smaller, and the cardiopulmonary function will be affected. Some children start panting without strenuous activities, and more serious ones may even affect their lifespan.

After understanding the incidence, hazards and causes of AIS, what kind of symptoms in children should alert us to the presence of scoliosis?

From an academic perspective, scoliosis refers to a three-dimensional spinal deformity in which one or more segments of the spine bend sideways and are accompanied by vertebral rotation. Back to daily life, we should pay more attention to children with one shoulder higher than the other; asymmetrical breast development in girls; a bulge on one side of the back; asymmetrical waistline; one hip higher than the other, etc. At this time, you can do some simple examinations on the child, such as touching the spinous process of the spine with your hand to see if it is in a straight line. You can also ask the child to take off his clothes, stand normally, bend forward and keep the knees upright. If the curvature of the spine is abnormal or the ribs are uneven, this disease can be highly suspected.

If any suspicious abnormalities are found, you should go to a regular medical institution for treatment and take a full spine X-ray to determine whether scoliosis exists and the severity of the scoliosis based on the degree of the "Cobb angle".

So what is the Cobb angle? First, we need to identify the upper and lower vertebrae of a scoliotic curve. Draw a horizontal line at the upper edge of the upper vertebrae and a horizontal line at the lower edge of the lower vertebrae. Draw a vertical line to each of the two horizontal lines. The intersection of the two vertical lines is the Cobb angle.

If the diagnosis is clear, regular treatment should be carried out according to the doctor's and physical therapist's instructions, and regular check-ups should be conducted to monitor changes in the condition. This is because correct treatment can stop further progression, restore the physiological curvature of the spine, achieve stability, maintain trunk balance, change the appearance of deformity, reduce or relieve back pain, and maximize the improvement and maintenance of cardiopulmonary function.

So in the end, the key point is to teach everyone how to prevent the occurrence of scoliosis.

Children need to be patiently taught to develop correct sitting and standing postures, maintain healthy spine habits and awareness, change sedentary behavior, correct bad standing and sitting postures, increase physical activity and physical exercise, and appropriately increase spine protection exercises. Correctly choose and use backpacks. It is recommended to use a double-shoulder backpack to ensure that the weight on both shoulders is as equal as possible. Provide adolescents with a balanced diet that is beneficial to bone health, promote healthy spinal development, and regularly adjust the height of study desks and chairs to suit height changes.

Let us “stand like a pine tree and sit like a bell” and share spinal health!

References

[1]YILMAZ H, ZATERI C, KUSVURAN OZKAN A, et, al. Prevalence of adolescent idiopathic scoliosis in Turkey: An epidemiological study[J]. Spine J, 2020, 20(6):947-955.

[2] Guo Haibin, Huang Jiaoling, Jin Hongfang. Screening and analysis of related factors for scoliosis in children in Qinghai Province[J]. Chinese Journal of General Practice, 2022(08): 1273-1282.