1. SCOLIOSIS A NURSING OVERVIEW Ann S. Goodson, R.N.,MSN,ONC Nurse Coordinator Pediatric/Orthopedics

2. SCOLIOSIS- CLASSIFICATION IDIOPATHIC IDIOPATHIC CONGENTIAL CONGENTIAL NEURO-MUSCULAR NEURO-MUSCULAR MISCELLANEOUS MISCELLANEOUS

3. NATURAL HISTORY of SCOLIOSIS  Scoliosis is a clinical sign

4. Tanner Staging

5. Risser Sign

7. Curve Patterns of Idiopathic Scoliosis

8. Idiopathic Scoliosis Risk of Progression

9. Non Surgical Management Observation Observation Bracing Bracing

10. SURGICAL TREATMENT

14. Congenital Scoliosis Vertebral Malformation

16. KYPHOSIS Congenital Kyphosis Congenital Kyphosis Scheuermann’s Disease Scheuermann’s Disease

19. TREATMENT Physical Therapy NSAID’sBracingSurgical

20. POSTURAL KYPHYOSIS “Round back” “Round back” Not Rigid Not Rigid Back ache Back ache Slouching Slouching

21. TREATMENT P.T. P.T. Exercises- Superman Exercises- Superman Sports Sports

22. NEUROMUSCULAR Cerebral palsy Cerebral palsy Muscular dystrophy Muscular dystrophy Myelomeningocele Myelomeningocele

28. MISCELLANEOUS Marfan Syndrome Marfan Syndrome Neurofibromatosis Neurofibromatosis Spine tumors Spine tumors Degenerative scoliosis Degenerative scoliosis

32. COMPLICATIONS COMPLICATIONS Spinal cord or nerve root injury Spinal cord or nerve root injury Infection Infection Pseudoarthrosis Pseudoarthrosis Crankshaft phenomenon Crankshaft phenomenon Implant failure Implant failure

33. SUMMARY SUMMARY Scoliosis is a diagnosis of exclusion Scoliosis is a diagnosis of exclusion Progression is related to growth in idiopathic and neuromuscular Progression is related to growth in idiopathic and neuromuscular Early diagnosis for brace treatment in idiopathic scoliosis- this is never a cure! Early diagnosis for brace treatment in idiopathic scoliosis- this is never a cure! Surgery is for large curves in growing children or progressive conditions Surgery is for large curves in growing children or progressive conditions

34. THANK-YOU !