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Forward bend test
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Ideally, a quick forward
bend test between the ages of 10 or 12 years will screen out almost all
potentially troublesome curvatures. The test consists of the child bending over
and touching his or her toes while keeping the legs straight. An observer looks
along the back to see if there are any differences on the two sides. Children in
families with an affected member should certainly have this very simple test
done—if necessary by parents. If they suspect a curvature then the procedure
is as follows.
 | Visit
your GP who will look at your back. If a curvature is confirmed, referral to
a scoliosis specialist is necessary rather than to a general orthopaedic
surgeon, who will simply refer the patient on to a specialist, thus
incurring further delay. If the GP feels that the curve is clinically
significant then a posteroanterior X-ray of the thoracic and lumbar spines
is helpful as a baseline (a standing up view from the back of the spine). |
| This
is not an emergency condition, but an outpatient waiting time of more than
four to six months is undesirable. |
| At
the first consultation in hospital, the scoliosis specialist
will examine the spine and take more X-rays to compare with the
previous X-ray and assess whether or not the curve is increasing. Some do,
some do not. The specialist may then recommend keeping an eye on the
curvature every 4–6 months during the period of growth until the age of 16
or so to ensure that the curve does not increase. If the curve is increasing
and is in excess of about 20° from the vertical (0° is straight) the
specialist may recommend bracing, which can
prevent the curve from increasing and occasionally it may actually produce a
long-term improvement in the curve. It may also reduce the rib prominence.
However, bracing will not work unless the child is fully compliant and wears
it for the length of time that the specialist specifies. |
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