Week Two Day One: Learning More About Scoliosis

Today was an overall comprehensive day. Out of the four days that I've done this internship, it was our busiest day and had the most amount of patient visits. I even got the chance to see four scoliosis patients, each with differing levels of scoliosis.

To be able to really have a comprehensive grasp on spinal fusion surgery, as well as the complications that happen following the surgery (which is my main focus on this project) I had to get a decent understanding of how scoliosis works, the categories it presents itself in, and other such things, meaning today was an overall learning day, filled with questions and quite a bit of reading.

The main categorization of scoliosis that I will be studying is called idiopathic, and specifically juvenile scoliosis. Idiopathic separates scoliosis by the time in which it appears by age. However, I learned that there are many other categories of scoliosis such as secondary, congenital, neuromuscular and constitutional.

I also learned how to measure a spinal curve.

This way of measuring the curve is called the Cobb method. It works by marking the endplate of the most deviated vertebrae and making a right angle on both. The resulting angle from the intersection is the degree of curvature. However, in Dr. Shindell's office, as I assume for most other orthopedic offices, the computer measures the curve for you, by drawing two lines at the most deviated vertebrae.

When it comes to juvenile scoliosis, in some cases it is caused by other underlying pathology such as a chiari malformation in the brain or Marfan syndrome, but over all it seems to be a genetic inheritance; although most scientists know that not every child of a parent who has scoliosis actually expresses the genes to the same extent, meaning they are currently researching more genetic background for the causes of this disorder.

One more final thing that I knew, however studied more today, is how most people notice scoliosis in their children or in others. When patients who have scoliosis bend down towards the ground, most of the time, there is something called a "rib hump" in which one rib is visibly higher than the other.

This is because when a child has scoliosis, the spine doesn't just curve to the side, it also twists to an extent and affect the ribs. When parents/friends see this in a child, it is a key indicator for scoliosis, as well as a visible curve in the spine when standing up with their bare back visible.

Overall I would say today was a very informational day, and I think this information will help me towards my overall goal for this project.