Guest guest Posted December 31, 2003 Report Share Posted December 31, 2003 I also have scoliosis and was diagnised as a child. I wore a whole body cast for 2 yrs and 4 mos and a corset brace for 2 yrs. Beginning in 6th grade. I was diagnosed with CMT after a pregnancy but I think I probably had a few symptoms from a child. Barbara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 31, 2003 Report Share Posted December 31, 2003 Thanks Gretchen, I am amazed at how much you do/have done for this group. You are full of knowledge. Thanks so much. Barbara BKay1941 > Barbara, you might find this interesting. Unfortunately, there is no > date on this piece, but it was in one of the newsletters. ~ G > > > Scoliosis in CMT Disease > by Dr. Kamal Ibrahim MD, FRCS© > > Scoliosis is a side to side or lateral curve of the spine. Sometimes > this side curve is very slight and can hardly be seen. In more severe > cases, however, the spine begins to look like a letter S or a long C. > The patient with true scoliosis may appear to slump or lean to one side. > This should not be confused with poor posture which corrects easily when > the patient simply stands up straight. When a patient with scoliosis > stands as straight as possible, the back is still not straight. > > In Charcot-Marie-Tooth disease, there is a muscle imbalance due to an > inherited > condition affecting the nervous system. As a result of this muscle > imbalance, scoliosis > could develop and continue to progress. > > Very little is written in the literature about scoliosis and > Charcot-Marie-Tooth disease, therefore this report is a result of review > of the literature and my personal experience. > > The incidence of scoliosis occurring along with Charcot-Marie-Tooth > disease is > about 10 per cent. That is to say, out of 100 patientss, 10 may develop > scoliosis. If the scoliosis occurs, it usually starts late in the first > decade of life or in teenagers. Half of those patients with scoliosis > and CMT will have a small to moderate degree of scoliosis which usually > does not progress and will not need any significant treatment while the > other half of the patients will have scoliosis which will progress > quickly and may end up needing surgical correction. This course of the > disease behaves somewhat similar to scoliosis in normal teenagers. > > Very little information is available in regard to scoliosis in adults > with CMT. From my experience, I believe that it will not occur in adults > de nouvelle, but usually it is a progression from adolescent scoliosis > which was not treated and continued to progress to a very significant > degree. > > KYPHOSIS ( " Round Back " ) > If the backward or rounded curve in the upper spine when viewed from the > side is too great (round shoulders or humped back, a condition called > kyphosis is present. When the inward or forward curve in the lower back > is too great the condition is called lordosis (swayback). Many patients > with scoliosis have kyphosis and lordosis as well. > > Kyphosis or excessive round back, sometimes called Scheuermann's > disease, is a common problem. It has to be distinguished from poor > posture. It is best seen in the > bending test. When the child with kyphosis bends forward there will be a > sharp bend or angulation of the back instead of the expected smooth > curve. > > > DIAGNOSIS > Children should be checked regularly every year, even by their parents. > The child should be asked to stand straight and the observer should look > at the child's back to notice any uneven shoulders or one shoulder blade > being more prominent, or the space between the body and the arms are > unequal, the hips may be uneven one appearing higher or more prominent > than the other, or if the child has some difficulty in clothes fitting > properly or having to adjust the hem of a skirt or slacks. When a person > with mild scoliosis bends at the waist, the sideways curvature of the > spine becomes more obvious and would appear as if there is a hump in the > back. That is to say one side of the back is higher than the other side. > If any of these findings are observed by the parents, then the child > should be examined by a physician and X-rays should be taken and > repeated every year or more frequently if the scoliosis shows > progression and is getting worse. > > TREATMENT > Treatment modalities in those patients and the result of treatment is > again similar to those of normal children who have scoliosis. > > If the curve is very mild, then the child should be observed. If he does > not show any progression, then no treatment is needed. Exercises have no > rule in correcting scoliosis, although back exercises are generally good > for the well-being of CMT patients. If the curve shows progression and > it is of a moderate degree, then a brace can control the progression > until the child matures which is around 14 years for girls and 16 years > for boys. Brace treatment is successful to achieve these results about > 80 per cent of the time. There are many kinds of braces used for > scoliosis, but generally they are divided into two groups, braces which > go all the way to the neck and braces which stop under the arm. Each > type of brace is used according to the part of the spine that has the > scoliosis. > > On the other hand if the scoliosis shows sudden and fast progression > toward a significant curve above 40 degrees, or if the brace treatment > is unsuccessful in controlling the scoliosis, then the advised treatment > is surgical correction of the scoliosis with fusion of the part of the > spine that is curving. > > The technique that is used now for this surgery involves inserting > stainless steel rods in each side of the spine, hooked to the spine with > multiple hooks. This way the curve can be corrected to a great extent > and fused in that position so the scoliosis does not come back. This > surgery is now performed with a great degree of safety using a > state-of-the-art technique which is known by the name of > Cotrel-Dubousset internal fixation. With this new technique patients > usually leave the hospital after one week from surgery without any cast, > brace or external support with great results and a high success rate. > The same techniques of surgery can be used for adults with scoliosis to > correct their curve and prevent further deterioration of the spine. > > In patients older than 50 years with very severe scoliosis, this surgery > might be risky and full of complications. Their symptom, which is > usually back pain, can be relieved with a body brace to work as an > external support to decrease the range of motion of the back, this way > the pain could be relieved. > > The complications of untreated, progressive scoliosis occur mainly in > late adulthood and are back pain and problems with heart and lung > functions. > > SUMMARY > In summary, scoliosis in CMT should be detected early in children during > the first and second decade of life and watched carefully. If it does > progress, then treatment should be implied in form of bracing or > surgical correction and fusion. For adults who have curves beyond > surgical treatment, they can be helped with a body brace, and if they > are using a wheelchair, then some scoliosis modification in the back of > the chair would be advised to help provide more comfortable seating and > prevent excessive back pain so that those patients will be able to deal > with daily living activities. > > > http://www.cmtworld.org > > http://www.neurologychannel.com/charcot/ > > > > > > > Quote Link to comment Share on other sites More sharing options...
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