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Ask the Expert: What is Scoliosis?
Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.
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7Dec
Class fee includes partner. The American Heart Association Family & Friends ” Child CPR & Choking” course is for those who want to learn CPR but do NOT need a course completion card in CPR for their job. This course is ideal for schools and students, new parents, grandparents, babysitters, and others interested in learning how to save a life. Skills are taught in a dynamic group environment using the AHA’s research-proven “practice-while-watching” technique, which provides students with the most hands-on CPR practice time possible. Please note: A child is someone older than one year who has not yet reached puberty. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Child CPR Class – for ages 1 year through puberty
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19May
Class fee includes partner. Please note: This class is a 2 in 1 class that includes the Newborn Care Class and Breastfeeding Basics and Beyond. The morning portion of this class will include breastfeeding benefits and techniques, the physiology of making milk, positioning and latch, how to know baby is getting enough milk, keeping up your milk supply, where to go for help, learn about our lactation consultants and breastfeeding forums. Pump rentals and a visit to our Lactation Connection resource center are also included in this class. The afternoon segment of this class will cover newborn appearances and behavior, daily care of the newborn, signs of illness, and when to call the doctor. Tummy time, comfort and soothing techniques, how to keep your baby safe, newborn screenings and vaccinations will also be discussed. Partners are encouraged to attend. A 30 minute lunch break is included in this class. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Nurturing Your Newborn
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5May
Class fee includes partner. This class is designed for expectant parents to gain knowledge on current research and recommendations, which promote necessary infant health, wellness and safety. Parents-to-be will learn how to care for their newborn, including bathing, diapering, cord care, signs of illness, nutrition, feeding, infant safety, understanding newborn behavior along with growth and development. To attend, please register using the expecting mother’s name and information. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Newborn Care Virtual Class
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8Dec
Class fee includes partner. This class is designed for expectant parents to gain knowledge on current research and recommendations, which promote necessary infant health, wellness and safety. Parents-to-be will learn how to care for their newborn, including bathing, diapering, cord care, signs of illness, nutrition, feeding, infant safety, understanding newborn behavior along with growth and development. To attend, please register using the expecting mother’s name and information. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Newborn Care Virtual Class
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24Nov
Class fee includes partner. The role of grandparents over the last several generations has changed a great deal. This informative class outlines ways grandparents can offer support and assistance to a new family while discussing current birth practices and infant care trends. Grandparents will learn about newborn care, safe sleep environments, breastfeeding, car seats, product safety, how to help new parents and more.. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Virtual Grandparents Workshop
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19Dec
Class fee includes partner. The American Heart Association Family & Friends “Infant CPR and Choking” (birth to one year) course is for those who want to learn infant CPR but do NOT need a course completion card in CPR for their job. This course is ideal for schools and students, new parents, grandparents, babysitters and others interested in learning how to save a life. Skills are taught in a dynamic group environment using the AHA’s research-proven “practice-while-watching” technique, which provides students with the most hands-on CPR practice time possible. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Infant CPR & Choking Class
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22Dec
Class fee includes partner. Please note: This class is a 2 in 1 class that includes the Newborn Care Class and Breastfeeding Basics and Beyond. The morning portion of this class will include breastfeeding benefits and techniques, the physiology of making milk, positioning and latch, how to know baby is getting enough milk, keeping up your milk supply, where to go for help, learn about our lactation consultants and breastfeeding forums. Pump rentals and a visit to our Lactation Connection resource center are also included in this class. The afternoon segment of this class will cover newborn appearances and behavior, daily care of the newborn, signs of illness, and when to call the doctor. Tummy time, comfort and soothing techniques, how to keep your baby safe, newborn screenings and vaccinations will also be discussed. Partners are encouraged to attend. A 30 minute lunch break is included in this class. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Nurturing Your Newborn
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17Aug
Class fee includes partner. This class helps prepare parents for emergencies that may occur in baby’s first year. Along with car seat safety and basic baby proofing, discussion will include prevention and treatment of common injuries. Students will also learn and practice the skills necessary to perform infant CPR (cardiopulmonary resuscitation), as well as the skills necessary to assist a choking infant. The American Heart Association Family & Friends “Infant CPR and Choking” (birth to one year) course is for those who want to learn Infant CPR but do not need a course completion card in CPR for their job. Grandparents and other caregivers are welcome to attend. This class covers the following topics: Car seat safety education Safe sleep Baby proofing your home Basic first aid Infant CPR & Choking If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Baby Safe Class
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18Aug
Class fee includes partner. Please note: This class is a 2 in 1 class that includes the Newborn Care Class and Breastfeeding Basics and Beyond. The morning portion of this class will include breastfeeding benefits and techniques, the physiology of making milk, positioning and latch, how to know baby is getting enough milk, keeping up your milk supply, where to go for help, learn about our lactation consultants and breastfeeding forums. Pump rentals and a visit to our Lactation Connection resource center are also included in this class. The afternoon segment of this class will cover newborn appearances and behavior, daily care of the newborn, signs of illness, and when to call the doctor. Tummy time, comfort and soothing techniques, how to keep your baby safe, newborn screenings and vaccinations will also be discussed. Partners are encouraged to attend. A 30 minute lunch break is included in this class. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Nurturing Your Newborn
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14Dec
Class fee includes partner. This class helps prepare parents for emergencies that may occur in baby’s first year. Along with car seat safety and basic baby proofing, discussion will include prevention and treatment of common injuries. Students will also learn and practice the skills necessary to perform infant CPR (cardiopulmonary resuscitation), as well as the skills necessary to assist a choking infant. The American Heart Association Family & Friends “Infant CPR and Choking” (birth to one year) course is for those who want to learn Infant CPR but do not need a course completion card in CPR for their job. Grandparents and other caregivers are welcome to attend. This class covers the following topics: Car seat safety education Safe sleep Baby proofing your home Basic first aid Infant CPR & Choking If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Baby Safe Class
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11Aug
Class fee includes partner. This class is designed for expectant parents to gain knowledge on current research and recommendations, which promote necessary infant health, wellness and safety. Parents-to-be will learn how to care for their newborn, including bathing, diapering, cord care, signs of illness, nutrition, feeding, infant safety, understanding newborn behavior along with growth and development. To attend, please register using the expecting mother’s name and information. If this class is sold out and you need to take a class please email Chris.Marlo@Renown.org or leave a message at 775-982-4352.
Read More About Newborn Care Virtual Class
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