Scoliosis

Definition

Scoliosis is a lateral (sideways) curvature of the spine greater than 10 degrees, often with rotational component. Most cases are idiopathic and detected during adolescent growth spurts.

Types

• Idiopathic (80%): Most common, adolescent onset.
• Congenital: Vertebral abnormalities.
• Neuromuscular: Cerebral palsy, muscular dystrophy.

Screening

Adam's forward bend test. Patient bends forward; examiner looks for asymmetric rib prominence (rib hump). Screening common in schools at ages 10 to 12. Confirm with x-ray and measure Cobb angle.

Treatment

• Less than 25°: Observation.
• 25 to 45°: Bracing (Boston, Milwaukee) during growth.
• Greater than 45°: Surgical spinal fusion.

Nursing Considerations

Educate adolescents on importance of bracing compliance (18 to 23 hours/day). Provide emotional support. Body image concerns. Post-op: pain control, neurologic checks, log-rolling, ambulation.

NCLEX Relevance

Adolescent girls most commonly affected. Adam's forward bend test.