Medical Management of Scoliosis

Medical Management of Scoliosis

Treatment depends on the cause, degree and location of the curve and the stage of bone growth.

If the curvature is less than 20%, usually require no treatment, but patients should perform regular checks every 6 months.

In children who are still growing, the curvature usually increased up to 25-30%, because it is usually advisable to use braces to help slow the progression of the curvature of the spine.

Braces of the "Milwaukee and Boston" is effective in controlling the progression of scoliosis, but must be installed for 23 hours / day until the child stops growing.
Brace ineffective in congenital and neuromuscular scoliosis.

If the curvature reached 40% or more, usually with surgery. In the surgery done to improve the curvature and fusion of the bones. Bone is maintained in place with the help of 1-2 metal tool attached to the bones recovered (less than 20 years). After the surgery may need to be fitted brace to stabilize the spine.

Sometimes given elektrospinal stimulation, in which the spinal muscles were stimulated with a low electrical current to straighten the spine.

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Pathophysiology of Scoliosis

Pathophysiology of Scoliosis

Deformity of the spine called scoliosis, originated from the nerves of weak or even paralyzed attractive segments of the spine. This serves to keep the pull of the vertebrae are in the normal lines of its shape like a ruler or straight. But for some reason, such as the habit of sitting the oblique, make the most of the work to be weak nerves. If this continues over and over becomes a habit, then the nerve will even die. This results in an imbalance of pull on the vertebrae. Therefore, suffering from scoliosis of the spine is curved like the letter or the letter S or C.

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Nursing Assessment for Scoliosis

Nursing Care Plan for Scoliosis : Nursing Assessment for Scoliosis

The physical examination includes:

a. Assessing the body's skeletal
The presence of deformity and alignment. Abnormal bone growth due to bone tumors. Shortening of the extremities, amputation and body parts that are not in anatomic alignment. Abnormal angulation of the long bones or motion at a point other than the joints usually indicate a fracture.

b. Assessing the spine
Scoliosis (lateral curvature of the spine deviation)

c. Assessing the joint system
Extensive movement are evaluated either actively or passively, deformity, stability, and bruising, stiffness of joints.

d. Assessing the muscle system
The ability to change position, muscle strength and coordination, and the size of each limb to mementau otot.Lingkar edema or atropfi, muscle pain.

e. Examine how to walk
The existence of irregular movements are not considered normal. If one limb shorter than the others. A variety of neurological conditions associated with abnormal gait (eg walking spastic hemiparesis - stroke, how to go step by step - lower motor neuron disease, how to walk vibrate - Parkinson's disease).

f. Examine the skin and peripheral circulation
Palpation of the skin may indicate a yanglebih temperature hotter or colder than others and adanyaedema. Peripheral circulation was evaluated by assessing peripheral pulses, color, temperature and capillary refill time.

Analysis of data
Subjektif Data :

• Back pain patients say
• Patients said fatigue in the spine after sitting or standing for long
• Patients say trouble breathing

Objective Data :

• That looks are not the same shoulder height
• Visible protrusion of the scapula is not the same
• Looks are not the same hip

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Impaired Physical Mobility Nursing Care Plan Scoliosis

Impaired Physical Mobility Nanda Definition: a nursing diagnosis approved by the North American Nursing Diagnosis Association, defined as the state in the which an individual has a Limitation in independent, purposeful physical movement of the body or of one or more extremities.


Alteration in mobility may be a temporary or more permanent problem. Most disease and rehabilitative states involve some degree of immobility (eg, as seen in strokes, leg fracture, trauma, morbid obesity, and multiple sclerosis). With the longer life expectancy for most Americans, the incidence of disease and disability Continues to grow. And with shorter hospital stays, Patients are being transferred to rehabilitation facilities or sent home for physical therapy in the home environment.

Mobility is also related to body changes from aging. Loss of muscle mass, reduction in muscle strength and function, stiffer and less mobile joints, affecting balance and gait changes can significantly compromise the mobility of elderly Patients. Mobility is paramount if elderly Patients are to maintain any independent living. Restricted movement affects the performance of most activities of daily living (ADLs). Elderly Patients are also at Increased risk for the complications of immobility. Nursing goals are to maintain functional ability, Prevent additional impairment of physical activity, and Ensure a safe environment.

Nursing Diagnosis for Scoliosis: Impaired Physical Mobility related to postural imbalance.

Purpose : Increase physical mobility

Plan of action
1. Assess the level of physical mobility.
Rational: Influencing choice / control the effectiveness of interventions.

2. Increase activity if pain is reduced.
Rationale: Provides the opportunity to release energy.

3. Teaching aids and active joint range of motion exercises.
Rationale: Increases muscle strength and circulation.

4. Involve the family in performing self-care.
Rational: The family that cooperate to relieve the officer, and provide comfort to patients.

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