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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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3Dec
Renown Institute for Cancer is teaming up with Renie Anderson, a trained and certified expert in cancer treatment side effect management. Attend this workshop in person at Renown Regional or virtually via Zoom to learn mind-body techniques to help you feel more connected and joyful in life as you move beyond cancer. This workshop includes: Emphasizing the importance of identifying resistance. Moving through resistance by understanding the concepts of acceptance and surrender. Identifying goals and visions. Creating action steps to help break patterns, to help you stay in a healthier mindset and feel more calm. There is no charge to attend this class. Video enabled attendance is available. Patients can access remotely and join from any video-enabled device. To receive the Zoom link to connect to this workshop, please email Renie Anderson @ renieanderson@att.net
Read More About Journey Beyond Your Cancer: Thrivorship Workshop
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4Dec
This support group provides support, education, networking, and resource materials to caregivers coping with a loved one diagnosed with cancer. In effort to provide the most supportive atmosphere for those caring for loved one dealing with cancer, this group is for current cancer caregivers only. If you have lost a loved one to cancer, there are these groups available for support: Grief Support Groups in Reno If you have cancer, Renown offers the following support groups: Cancer Support Group Men’s Prostate Cancer Support Group Newly Diagnosed Breast Cancer Orientation Class Lymphedema Education & Risk Reduction Class * Virtual attendance is available. Link will be sent one day before meeting to email provided on registration.
Read More About Cancer Caregiver Support Group
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5Dec
This group is for all patients facing cancer. The meeting enables participants to share experiences and express feelings and concerns. All cancer patients, family members, survivors, and caregivers are welcome to attend. Meets weekly on Thursday from 11:30 a.m. – 1 p.m. in person and virtually. For directions to Sierra Cafe 104, please use the following link: Campus and Parking Maps | Renown Health Click on the “Renown Regional Medical Center Visitor Guide” to download the PDF map. Sierra Cafe 104 is located on the 1st Floor of the Sierra Tower past the gift shop on the right as you enter the Sierra Cafe. Video enabled attendance available. You can access remotely and join from any video-enabled device (smart phone, iPad, laptop, or webcam/desktop). A virtual invitation with instructions on how to connect will be sent via email the Wednesday before the meeting.
Read More About Cancer Support Group
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31Oct
This group is for all patients facing cancer. The meeting enables participants to share experiences and express feelings and concerns. All cancer patients, family members, survivors, and caregivers are welcome to attend. Meets weekly on Thursday from 11:30 a.m. – 1 p.m. in person and virtually. For directions to Sierra Cafe 104, please use the following link: Campus and Parking Maps | Renown Health Click on the “Renown Regional Medical Center Visitor Guide” to download the PDF map. Sierra Cafe 104 is located on the 1st Floor of the Sierra Tower past the gift shop on the right as you enter the Sierra Cafe. Video enabled attendance available. You can access remotely and join from any video-enabled device (smart phone, iPad, laptop, or webcam/desktop). A virtual invitation with instructions on how to connect will be sent via email the Wednesday before the meeting.
Read More About Cancer Support Group
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11Nov
Renown Institute for Cancer is teaming up with Renie Anderson, a trained and certified expert in cancer treatment side effect management. Attend this workshop in person at Renown Regional or virtually via Zoom to learn mind-body techniques to help reduce stress and fears while caring for your loved one going through treatment. There is relief in knowing you are not alone. This workshop includes: Identifying and talking about fears, resistance and frustrations. Creating end results to help them re-frame the discussion. Learning tools to help identify needs and wants; being able to ask for them so you can refuel and become more available to yourself and your loved ones for the long haul. Learning about the available options. There is no charge to attend this class. Video enabled attendance is available. Patients can access remotely and join from any video-enabled device. To receive the Zoom link to connect to this workshop, please email Renie Anderson @ renieanderson@att.net
Read More About Journey Through Your Cancer and Beyond: Caregiver Workshop
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29May
This support group provides support, education, networking, and resource materials to caregivers coping with a loved one diagnosed with cancer. In effort to provide the most supportive atmosphere for those caring for loved one dealing with cancer, this group is for current cancer caregivers only. If you have lost a loved one to cancer, there are these groups available for support: Grief Support Groups in Reno If you have cancer, Renown offers the following support groups: Cancer Support Group Men’s Prostate Cancer Support Group Newly Diagnosed Breast Cancer Orientation Class Lymphedema Education & Risk Reduction Class *Virtual attendance is available. Link is sent one day before the meeting to email provided on registration.
Read More About Cancer Caregiver Support Group
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8May
This class is for anyone who has undergone or is undergoing breast cancer treatment and will focus on lymphedema education and reducing the risk of its occurrence. During the class, we will review the basic anatomy of the lymphatic system and define common procedures performed during the treatment course for breast cancer that affects lymphatics. Risk reduction strategies, including compression sleeves, will be reviewed in addition to the typical presentation of early lymphedema. Finally, a brief description of Axillary Web Syndrome will also be reviewed, and basic stretches/exercises to implement if cording is present.
Read More About Lymphedema Education and Risk Reduction Class
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1Oct
Renown Institute for Cancer is teaming up with Renie Anderson, a trained and certified expert in cancer treatment side effect management. Attend this workshop in person at Renown Regional or virtually via Zoom to learn mind-body techniques to help you feel more connected and joyful in life as you move beyond cancer. This workshop includes: Emphasizing the importance of identifying resistance. Moving through resistance by understanding the concepts of acceptance and surrender. Identifying goals and visions. Creating action steps to help break patterns, to help you stay in a healthier mindset and feel more calm. There is no charge to attend this class. Video enabled attendance is available. Patients can access remotely and join from any video-enabled device. To receive the Zoom link to connect to this workshop, please email Renie Anderson @ renieanderson@att.net
Read More About Cancer Support Virtual Workshop 3: Thrivorship – After Cancer Care
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1Oct
Renown Institute for Cancer is teaming up with Renie Anderson, a trained and certified expert in cancer treatment side effect management. Attend this workshop in person at Renown Regional or virtually via Zoom to learn mind-body techniques to help you feel more connected and joyful in life as you move beyond cancer. This workshop includes: Emphasizing the importance of identifying resistance. Moving through resistance by understanding the concepts of acceptance and surrender. Identifying goals and visions. Creating action steps to help break patterns, to help you stay in a healthier mindset and feel more calm. There is no charge to attend this class. Video enabled attendance is available. Patients can access remotely and join from any video-enabled device. To receive the Zoom link to connect to this workshop, please email Renie Anderson @ renieanderson@att.net
Read More About Journey Beyond Your Cancer: Thrivorship Workshop
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10Oct
This group is for all patients facing cancer. The meeting enables participants to share experiences and express feelings and concerns. All cancer patients, family members, survivors, and caregivers are welcome to attend. Meets weekly on Thursday from 11:30 a.m. – 1 p.m. in person and virtually. For directions to Sierra Cafe 104, please use the following link: Campus and Parking Maps | Renown Health Click on the “Renown Regional Medical Center Visitor Guide” to download the PDF map. Sierra Cafe 104 is located on the 1st Floor of the Sierra Tower past the gift shop on the right as you enter the Sierra Cafe. Video enabled attendance available. You can access remotely and join from any video-enabled device (smart phone, iPad, laptop, or webcam/desktop). A virtual invitation with instructions on how to connect will be sent via email the Wednesday before the meeting.
Read More About Cancer Support Group
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19Dec
This group is for all patients facing cancer. The meeting enables participants to share experiences and express feelings and concerns. All cancer patients, family members, survivors, and caregivers are welcome to attend. Meets weekly on Thursday from 11:30 a.m. – 1 p.m. in person and virtually. For directions to Sierra Cafe 104, please use the following link: Campus and Parking Maps | Renown Health Click on the “Renown Regional Medical Center Visitor Guide” to download the PDF map. Sierra Cafe 104 is located on the 1st Floor of the Sierra Tower past the gift shop on the right as you enter the Sierra Cafe. Video enabled attendance available. You can access remotely and join from any video-enabled device (smart phone, iPad, laptop, or webcam/desktop). A virtual invitation with instructions on how to connect will be sent via email the Wednesday before the meeting.
Read More About Cancer Support Group
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