In scoliosis growth plays a major role. The degree of deformity that we have in the column increases to the rate of growth. Because of this, it is key to understand the relationship between growth and scoliosis to make proper follow-up and treatment.
There is a particular period in which most of the growth takes place, what we call “the lug”. During those years a more exhaustive follow-up of scoliosis is very important because it is when more risk has to worsen the deformity. That is why we must have as many clues as possible about when it will happen and what will last.
When we first detect a scoliosis, knowing the growth phase in which it is has a lot of value for the prognosis. Broadly speaking, if we start to have scoliosis at a very young age, the risk of the curve getting bigger increases because we have a lot more to grow. On the contrary, if we detect the deformity in the column at a time when we have almost finished growing, the deformity will most likely be limited.
All this is very important in deciding the treatment that should or should not be applied.
Understanding The Relationship Between Growth And Scoliosis, How Much Is Left To Grow My Child?
We have already reflected the importance of controlling growth and skeletal maturity. How do we do it? In the consultation we take into account a series of data that place us in the moment of skeletal maturity and growth that the person finds.
– The date of the first rule. The growth process in girls is different than in boys. In children it lasts more years and is something more progressive. Girls give the main draw at the time of their life that is around the first rule. At this time we must pay close attention to scoliosis. Once they have had their first rule they have approximately two years of significant growth remaining.
Growth and scoliosis- Risser’s Sign: One method to see skeletal maturity is x-rays. In children there are areas of bone called growth cartilage. While these zones are present we know that there is still growth. Moreover, they are disappearing in a certain order and this gives us clues about the phase in which we are. The so-called sign of Risser is the evolution of this maturation that we can see in a pelvic x-ray. This is very useful because we use the same X-ray column to see skeletal maturity. The ossification of the iliac crest (the area of the pelvis we see in the image) can be divided into 6 stages (from 0 to 5). We say Risser 0 when there are no signs of ossification and Risser 5 when the ossification process is complete. The other four levels are stages of the process. Risser 1 refers to the first 25%. Risser 2, from 26 to 50%. Risser 3, from 51 to 75%. Risser 4, from 76%.
– Other radiographic signs. The Risser sign is the one we use most but there are others that can be useful in some cases. They work by the same principle as we have told before. By making an x-ray of the wrist and hand we have the so-called Tanner-Whitehouse Test . There are others based on an elbow X-ray. In short, all these methods give us much information about what we have left to grow.
– Size. Whenever we review a patient with scoliosis we must measure their height. Height is a very simple measure to take that gives us a lot of information. It allows us to detect when the “spin” is occurring, which is the time when we should be more alert to the development of scoliosis. And not only that. If the stature does not increase all that it should according to the rest of the data that we have commented, it can be an indirect sign that the curve has increased.
– Stays of Tanner. It is an atlas that determines the development phase in function of the physical changes that the child presents in his genitals, pubic hair and mammary region.
In summary, using some of the data we have discussed gives us an idea of the growth phase. We can know the moment of greater growth that will force us to monitor scoliosis more closely. We will also be able to know when the growth has come to an end and, therefore, it may be time to remove the corset.
Visit the ultimate guide to forget your depression.