ASTHMA...WRITTEN BY OPEOLUWA KOFOWOROLA ADETOLA

Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that you are allergic to or find irritating. When your airways react, they get narrower and your lungs get less air. This can cause wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night. 

When your asthma symptoms become worse than usual, it's called an asthma attack. In a severe asthma attack, the airways can close so much that your vital organs do not get enough oxygen. People can die from severe asthma attacks. 

• Asthma is not a psychological condition. However, emotional triggers can cause flare-ups. 

• You cannot outgrow asthma. In about 50% of children with asthma, the condition may become inactive in the teenage years. The symptoms, however, may reoccur anytime in adulthood. 

• There is no cure for asthma, but the disease can be controlled in most patients with good medical care. The condition should be taken seriously, since uncontrolled asthma may result in emergency hospitalization and possible death. 

• You have a 6% chance of having asthma if neither parent has the condition, a 30% chance if one parent has it, and a 70% chance if both parents have it. 

• Asthma is not contagious. 

• A new environment may temporarily improve asthma symptoms, but it will not cure asthma. After a few years in the new location, many people become sensitized to the new environment and the asthma symptoms return with the same or even greater intensity than before. 

• swimming is an optimal exercise for those with asthma. On the other hand, exercising in dry, cold air may be a trigger for asthma in some people. 

• Asthma is best controlled by having an asthma management plan designed by your doctor that includes the medications used for quick relief and those used as controllers. 

• Asthma medications are not addictive. 

• Asthma attacks cannot be faked. In rare cases, there is a psychological condition known by a variety of names (factious asthma, spastic dysphonia, globus hystericus) where emotional issues may cause symptoms that mimic the symptoms of asthma.

Typical Asthma Symptoms and Signs
The symptoms of asthma vary from person to person and in any individual from time to time. It is important to remember that many of these symptoms can be subtle and similar to those seen in other conditions. All of the symptoms mentioned below can be present in other respiratory, and sometimes, in heart conditions. This potential confusion makes identifying the settings in which the symptoms occur and diagnostic testing very important in recognizing this disorder.

The following are the four major recognized asthma symptoms:
• Shortness of breath, especially with exertion or at night
• Wheezing is a whistling or hissing sound when breathing out
• Coughing may be chronic, is usually worse at night and early morning, and may occur after exercise or when exposed to cold, dry air
• Chest tightness may occur with or without the above symptoms 

Allergies Can Cause Asthma
Allergies with asthma is a common problem. Eighty percent of people with asthma have allergies to airborne substances such as tree, grass, and weed pollens, mold, animal dander, dust mites, and cockroach particles. In one study, children who had high levels of cockroach droppings in their homes were four times more likely to have childhood asthma than children whose homes had low levels. Asthma exacerbation after dust exposure is usually due to dust mite allergy.

Food and Food Additives Trigger Asthma
While it's not common for food allergies to cause asthma, food allergies can cause a severe life-threatening reaction. The most common foods associated with allergic symptoms are:
• Eggs
• Cow's milk
• Peanuts
• Soy
• Wheat
• Fish
• Shrimp and other shellfish
• Salads & fresh fruits
Food preservatives can also trigger asthma. Sulfite additives, such as sodium bisulfite, potassium bisulfite, sodium metabisulfite, potassium metabisulfite, and sodium sulfite, are commonly used in food processing or preparation and may trigger asthma in those people who are sensitive.

Asthma medications
Asthma medication plays a key role in gaining good control of your condition. Asthma is a chronic disease that involves inflammation of the airways superimposed with recurrent episodes of decreased airflow, mucus production, and symptoms such as wheezing, chest tightness, shortness of breath, and cough. Controlling your asthma is crucial in avoiding asthma attacks and living an active life.

Treatment with asthma medication focuses on:
• Controlling inflammation and preventing symptoms (controller medication) 

• Easing asthma symptoms when a flare-up occurs (quick-relief medication)

There are two general types of asthma medication which can give you long-term control or quick relief of symptoms.
• Controller Medication. This is the most important type of therapy for most people with asthma because these asthma medications prevent asthma attacks on an ongoing basis. As a result of controller medications, airways are less inflamed and less likely to react to triggers. Steroids, also called "corticosteroids," are an important type of anti-inflammatory medication for people suffering from asthma. These asthma drugs reduce inflammation, swelling, and mucus production in the airways. Some people may combine use of an inhaled steroid with an inhaled long-acting beta-agonist (LABA). LABAs help keep airways open by relaxing the muscles around the airways. They should only be used along with an inhaled steroid for the treatment of asthma. Leukotriene modifiers are also used to control asthma and prevent symptoms. They target inflammatory chemicals in the body that lead to swelling of the airways and mucus production. 

• Quick Relief Medication. These asthma medications are also called rescue medications and consist of short-acting beta-agonists (SABA). They relieve the symptoms of asthma by relaxing the muscles that tighten around the airways. This action rapidly opens the airways, letting more air come in and out of the lungs. As a result, breathing improves. Using these as a rescue medication more than twice a week indicates that your asthma is not well controlled. SABAs are also used prior to exercise to prevent symptoms in people who have exercise-induced asthma. 

These asthma drugs can be administered in different ways. Successful treatment should allow you to live an active and normal life. If your asthma symptoms are not controlled, you should contact your doctor for advice and look at a different asthma medication that may work better for you.

HAIR LOSS IN WOMEN

One of the most emotionally devastating concerns I hear about from many female patients is thinning hair and hair loss. We understand that a woman’s head of hair is her crowning glory — and losing too much hair can be a serious and frightening blow to her self-esteem.

The advertisements for treatment of balding and hair loss in men can't be missed. These ads might lead one to believe that hair loss is generally an issue affecting men. However, the fact is that as many as two-thirds of all women experience hair loss at some point. Fortunately, hair loss in women typically does not result in complete baldness, as is often the case with men.

What is hair loss in women?

One of the commonest forms of hair loss in women (and men) is a condition called telogen effluvium, in which there is a diffuse (or widely spread out) shedding of hairs around the scalp and elsewhere on the body.

This is usually a reaction to intense stress on the body's physical or hormonal systems, or as a reaction to medication.

The condition, which can occur at any age, generally begins fairly suddenly and gets better on its own within about six months, although for a few people it can become a chronic problem.

Because telogen effluvium develops a while after its trigger, and causes generalized thinning of hair density rather than a bald patch, women with the condition can easily be diagnosed as overanxious or neurotic.

Fortunately, it often gets better with time. Telogen effluvium is a phenomenon related to the growth cycles of hair.

Hair growth cycles alternate between a growth phase (called anagen, it lasts about three years) and a resting phase (telogen, which lasts about three months). During telogen, the hair remains in the follicle until it is pushed out by the growth of a new hair in the anagen phase.

At any one time, up to about 15 per cent of hairs are in telogen. But a sudden stress on the body can trigger large numbers of hairs to enter the telogen phase at the same time. Then, about three months later, this large number of hairs will be shed. As the new hairs start to grow out, so the density of hair may thicken again.

Many adults have had an episode of telogen effluvium at some point in their lives, reflecting episodes of illness or stress.

Another common type of hair loss in women is androgenetic alopecia, which is related to hormone levels in the body. There's a large genetic predisposition, which may be inherited from the father or mother.

Androgenetic alopecia affects roughly 50 per cent of men (this is the main cause of the usual pattern of balding seen as men age) and perhaps as many women over the age of 40.

Research shows that up to 13 per cent of women have some degree of this sort of hair loss before the menopause, and afterwards it becomes far more common - one piece of research suggests that over the age of 65 as many as 75 per cent of women are affected.

The cause of hair loss in androgentic alopecia is a chemical called dihydrotestosterone, or DHT, which is made from androgens (male hormones that all men and women produce) by the action of an enzyme called 5-alpha reductase.

People with a lot of this enzyme make more DHT, which in excess can cause the hair follicles to make thinner and thinner hair, until eventually they pack up completely.

Women's pattern of hair loss is different to the typical receding hairline and crown loss in men. Instead, androgenetic alopecia causes a general thinning of women's hair, with loss predominantly over the top and sides of the head.

Another important cause of hair loss in women is a condition called alopecia areata, an autoimmune disease that affects more than two per cent of the population. In this, the hair follicles are attacked by white blood cells. The follicles then become very small and hair production slows down dramatically, so there may be no visible hair growth for months and years.

After some time, hair may regrow as before, come back in patchy areas, or not regrow at all. The good news is that in every case the hair follicles remain alive and can be switched on again; the bad news is that we don't yet know how to do this.

Myths Vs. Facts
Myth: Hair loss is inherited from your father	Fact: Both parents' genes are a factor.	Androgenetic aplopecia is genetically-linked hair thinning.
Myth: Female pattern hair loss causes abnormal bleeding.	Fact: Menstruation is not affected.	Hair loss typically begins between the ages of 12 and 40.
Myth: Extensive hormonal evaluation is required.	Fact: Hormonal evaluation is only required if the patient is also experiencing irregular periods, infertility, hirsutism, cystic acne, virilization, or glactorrhea.	Androgenetic aplopecia usually doesn't cause menstrual issues or interfere with pregnancy or endocrine function.
Myth: Teasing, using hair color, other products, or frequently washing hair increases hair loss.	Fact: Normal hair care doesn't affect hair loss.	The only drug approved for promoting hair growth in women is Minoxidil.

CHRONIC FATIGUE SYNDROME

Fatigue is one of the most common symptoms in clinical medicine; nevertheless, fatigue may be difficult to define because it is rather loosely partitioned into physical and mental components. Fatigue often proves evanescent or, if chronic, relates to an underlying systemic illness. Fatigue may also be associated with a psychiatric disorder. Less commonly, patients may have chronic persistent fatigue that lasts longer than 6 months without an apparent etiology and that is associated with exercise intolerance, sleep difficulties, and an inability to perform mental or physical activities in a competent fashion.

Because a healthy body requires robust, functionally integrated organ systems to ensure optimal operation, intact organ parenchyma, intact organ regulatory systems, and intact delivery of nutrients and oxygen to the tissues by the cardiovascular-circulatory system must be present to avoid malfunction. Any defect in these 3 components causes organ dysfunction. Signals sent via the nervous system indicating such dysfunction may be perceived as pain or fatigue. If dysfunction progresses to critical organ impairment, the organ system may ultimately fail; however, more gradual and persistent decline in function of single or multiple organ systems can produce a chronic fatigue state without complete organ system breakdown.

The etiology of organ fatigue remains elusive, and, indeed, the precise definition of fatigue remains controversial. Nevertheless, standardized questionnaires and examinations are currently used to assess fatigue and to separate mental fatigue from physical fatigue on the basis of general physical condition and on the ability to perform cognitive or muscle tasks in an age-appropriate fashion.

Chronic fatigue syndrome defined

As a distinct clinical entity, chronic fatigue syndrome (CFS) has only recently been defined for adults as a distinct disorder characterized by chronic (often relapsing but always debilitating) fatigue lasting at least 6 months (occasionally lasting much greater lengths of time), which causes impaired overall physical and mental functioning.Because a precise etiology for the syndrome remains elusive, the diagnosis is largely made once specific medical and psychiatric disorders are excluded. Therefore, stating that CFS is an illness primarily characterized in adults by self-reported symptoms with a relative paucity of physical findings may be fair.

                                            DIAGNOSIS

The most recent CDC diagnostic criteria state:

In order to receive a diagnosis of chronic fatigue syndrome, a patient must satisfy two criteria: 1) Have severe chronic fatigue of 6 months or longer duration with other known medical conditions excluded by clinical diagnosis; and 2) concurrently have 4 or more of the following symptoms:

·                            Substantial impairment in short-term memory or concentration

·                            Sore throat

·                            Tender lymph nodes

·                            Muscle pain

·                            Multi-joint pain without swelling or redness

·                            Headaches of a new type, pattern or severity

·                            Unrefreshing sleep

·                            Postexertional malaise lasting more than 24 hours.

The symptoms must have persisted or recurred during 6 or more consecutive months of illness and must not have predated the fatigue.

In addition, a large number of clinically defined, frequently treatable illnesses can result in fatigue. Diagnosis of any of these conditions excludes a definition of CFS unless the condition has been treated sufficiently and no longer explains the fatigue and other symptoms. These conditions include hypothyroidism, sleep apnea and narcolepsy, major depressive disorders, chronic mononucleosis, bipolar affective disorder, schizophrenia, eating disorders, cancer, autoimmune disease, hormonal disorders, subacute infections, severe obesity, alcohol or substance abuse, and reactions to prescribed medications.

Preventing CFS

Since it's not known what causes CFS, it's difficult to prevent. There's no evidence to support the view that CFS is a contagious disease and there's no precise identified cause.

It's believed that a person’s genes may make them more susceptible, and that viral infection, stress, depression, or a major life event (for example bereavement, job loss) may act as triggers for CFS to develop in susceptible individuals.

In some cases a specific disease, such as an underactive thryoid gland or a head injury, can be identified as the underlying cause of the sort of symptoms typically found in CFS. A range of tests and investigations are done when a person first consults their doctor with symptoms, in order to check for these diagnoses and rule out them out as a cause. So CFS remains a diagnosis of exclusion (where all other identifiable medical causes for symptoms have been ruled out).

Self-Care at Home

Physical activity performed at a comfortable pace is important for everyone to maintain good health, including people with chronic fatigue syndrome. People with CFS need to learn how much activity is helpful and when to stop, so they do not increase their level of fatigue.

In general, people with CFS should pace themselves carefully and avoid excessive physical or emotional stress. Remember, the goal is to avoid increasing fatigue or pain. Maintain a regular and manageable daily routine to avoid a relapse or increase of symptoms. Exercise should be supervised by a knowledgeable health-care provider or physical therapist.

Total rest should also be avoided as it may make your fatigue worse. You should maintain physical activity at a comfortable pace. If you increase your level of physical activity, do so gradually.

Decreased consumption of alcohol and caffeine at night may help you sleep.

Try to minimize social isolation.

10 MOST EXPENSIVE MEDICAL CONDITIONS

Over the course of a year two out of every 1,000 people will rack up $100,000 or more in medical bills. These are the “high cost patients” who make insurance premiums go up and bedevil policy makers. These are people who are really sick.

The conventional wisdom is that with better prevention, wellness, care-coordination, insurance reforms, and so forth, medical spending could be averted. But one thought I’ve had, in response, was that a lot of the really sick people I’ve known are suffering from maladies like cancer or dementia that are not so easily preventable or avoidable.

There’s a lot of hand-wringing about how expensive our medical system has become. But what if it’s because we take good care of people who are sick and need the help? (God forbid!)

I recently came across a report commissioned last year on this topic by Genentech. The biotechnology unit of Roche produces expensive but effective therapies for serious conditions like colon cancer and age-related macular degeneration. Genentech has a special interest in, and one might even argues contributes to, high-cost care.

Milliman, the actuarial firm, performed the analysis and made some interesting discoveries. For background: Milliman is based in Seattle, works with major payers, providers and employers on health care costs, and provided this report to me for free. (You can read it here.)

The ten events or conditions that are most commonly expensive are as follows. These are average costs, so many patients even with these conditions will not reach the $100,000 per year mark:

1. HIV $25,000

2. Cancer $49,000

3. Transplant $51,00

4. Stroke $61,000

5 Hemophilia $62,000

6. Heart Attack including Cardiac Revascularization (Angioplasty with or without Stent) $72,000

7. Coronary Artery Disease $75,000

8. Neonate (premature baby) with extreme problems $101,000

9. End-Stage Renal Disease $173,000

10. Respiratory Failure on Ventilator $314,000

The most expensive condition, respiratory failure on a ventilator, is another way of describing the intensive care that patients receive at the end of life for a variety of conditions. Kidney failure may be from diabetes or hypertension, both of which could have been preventable.

Hemophilia is obviously congenital. Cancer is not always preventable. Being born early can sometimes be the result of insufficient prenatal care, or just bad luck. Heart disease, as the number one killer in the country, is expensive to treat, though not the most expensive.

I was surprised how low cancer was on the list. The report provides a bit more detail. If you have cancer that’s not being intensively treated (no chemotherapy, no surgery) it costs only $14,000 a year. This would apply to 40% of total cancer patients. However, cancer patients who receive surgery or chemotherapy (15% of the total) cost $123,000 on average. It wasn’t clear how the other 35% are classified.

Some terminal cancer cases may end up as ICU patients. (So they may be double-represented on a list like this.) But most cancer patients are not “catastrophic” according to the report. Overall, cancer affects about 4% of the total population of a health insurance plan.

The Milliman paper had a few other interesting findings worth reporting. Costs total $4,000 per year per capita. Maternity care costs about $9,000 per year including when C-sections are necessary. Diabetes patients represent between 2% and 3% of a health insurance plan’s population and can cost quite a bit to treat. But on average, diabetics’ costs range around $10,000 a year.

Milliman warns that for high-cost patients it is risky to use conventional insurance plan design tactics to try to reduce expenses. A $30 copayment instead of a $10 one is not going to change the overall budget when the care costs $100,000. By upping coinsurance–where you make patients pay 20% of the total cost, for example–you could make the clinical outcome worse by reducing compliance. To use the classic example: a diabetic might take fewer medications and end up in the hospital.

Think about the impact of increasing coinsurance for someone with cancer or hemophilia. It wouldn’t make care cheaper or better. But you would be sticking vulnerable patients with thousands of dollars of out-of-pocket bills. Here care-coordination might lead to greater savings. Milliman recommends designing health plans that are generous for high-cost patients.

The verdict, as I read it: As long as there are sick people there will be high-cost patients. It’s not a problem that’s so easily solved.

POLIO

Polio (also called poliomyelitis) is a contagious, historically devastating disease that was virtually eliminated from the Western hemisphere in the second half of the 20th century. Although polio has plagued humans since ancient times, its most extensive outbreak occurred in the first half of the 1900s before the vaccination created by Jonas Salk became widely available in 1955.

At the height of the polio epidemic in 1952, nearly 60,000 cases with more than 3,000 deaths were reported in the United States alone. However, with widespread vaccination, wild-type polio, or polio occurring through natural infection, was eliminated from the United States by 1979 and the Western hemisphere by 1991.

Signs and Symptoms

Polio is a viral illness that, in about 95% of cases, actually produces no symptoms at all (called asymptomatic polio). In the 4% to 8% of cases in which there are symptoms (called symptomatic polio), the illness appears in three forms:

1.                    a mild form called abortive polio (most people with this type may not even suspect they have it because their sickness is limited to mild flu-like symptoms such as mild upper respiratory infection, diarrhea, fever, sore throat, and a general feeling of being ill)

2.                    a more serious form associated with aseptic meningitis called nonparalytic polio (1%-5% show neurological symptoms such as sensitivity to light and neck stiffness)

3.                    a severe, debilitating form called paralytic polio (this occurs in 0.1%-2% of cases)

People who have abortive polio or nonparalytic polio usually make a full recovery. However, paralytic polio, as its name implies, causes muscle paralysis — and can even result in death.

In paralytic polio, the virus leaves the intestinal tract and enters the bloodstream, attacking the nerves (in abortive or asymptomatic polio, the virus usually doesn't get past the intestinal tract). The virus may affect the nerves governing the muscles in the limbs and the muscles necessary for breathing, causing respiratory difficulty and paralysis of the arms and legs.

Contagiousness

Polio is transmitted primarily through the ingestion of material contaminated with the virus found in stool (poop). Not washing hands after using the bathroom and drinking contaminated water were common culprits in the transmission of the disease.

Prevention

In the United States, it's currently recommended that children have four doses of inactivated polio vaccination (IPV) between the ages of 2 months and 6 years.

By 1964, the oral polio vaccine (OPV), developed by Albert Sabin, had become the recommended vaccine. OPV allowed large populations to be immunized because it was easy to administer, and it provided "contact" immunization, which means that an unimmunized person who came in contact with a recently immunized child might become immune, too.

The problem with OPV was that, in very rare cases, paralytic polio could develop either in immunized children or in those who came in contact with them. Since 1979 (when wild polio was eliminated in the United States), the approximately 10 cases per year of polio seen in this country were traced to OPV.

IPV is a vaccine that stimulates the immune system of the body (through production of antibodies) to fight the virus if it comes in contact with it. IPV cannot cause polio.

In an effort to eradicate all polio, including those cases associated with the vaccine, the Centers for Disease Control and Prevention (CDC) decided to make IPV the only vaccine given in the United States. Currently, the CDC and American Academy of Pediatrics (AAP) recommend three spaced doses of IPV given before the age of 18 months, and an IPV booster given between the ages of 4 to 6, when children are entering school.

If you're planning to travel outside the United States, particularly to Africa and Asia (where polio still exists), be sure that you and your kids have received a complete set of polio vaccinations.

Duration

Although the acute illness usually lasts less than 2 weeks, damage to the nerves could last a lifetime. In the past, some patients with polio never regained full use of their limbs, which would appear withered. Those who did fully recover might go on to develop post-polio syndrome (PPS) as many as 30 to 40 years after contracting polio. In PPS, the damage done to the nerves during the disease causes an acceleration of the normal, gradual weakness due to aging.

Treatment

During the height of the polio epidemic, the standard treatment involved placing a patient with paralysis of the breathing muscles in an "iron lung" — a large machine that actually pushed and pulled the chest muscles to make them work. The damaged limbs were often kept immobilized because of the confinement of the iron lung. In countries where polio is still a concern, ventilators and some iron lungs are still used.

Historically, home treatment for paralytic polio and abortive polio with neurological symptoms wasn't sufficient. However, asymptomatic and mild cases of abortive polio with no neurological symptoms were usually treated like the flu, with plenty of fluids and bed rest.

The Future of Polio

The World Health Organization (WHO) is working toward eradicating polio throughout the world. Significant strides have already been made. In 1988, 355,000 cases of polio in 125 countries were reported. By the end of 2004, there were just 1,255 cases.

Four countries (Afghanistan, India, Nigeria, and Pakistan) still have polio circulating, and the virus could be introduced to other countries. If the polio virus is imported into a country where not enough people have been immunized, there's the risk that it could spread from person to person. That's what has happened in some countries in Africa and Asia. So until it has been eliminated worldwide, it's important to continue vaccinating kids against polio.

SCOLIOSIS..SPINAL CURVATURE

Unless you have somebody who is directly affected, this may be the first time you are hearing about the term ‘scoliosis’.  It is a medical condition in which a person's spine is curved from side to side;  the spine of an individual with scoliosis may look more like an "S" or a "C", rather than a straight line. Scoliosis is typically classified as either congenital, idiopathic(cause unknown), or neuromuscular (having developed as a secondary symptom of another condition, such as spina bifida, cerebral palsy, spinal muscular atrophy, or physical trauma). A lesser known underlying cause of scoliosis could be attributed to a condition called Chiari malformation. Scoliosis affects girls twice as often as it affects boys. About three to five of 1,000 people are affected. Scoliosis usually occurs in those older than 10 years, but the condition can be seen in infants.

 Scoliosis Causes

In most cases (85%), the cause of scoliosis is unknown (what doctors call idiopathic). The other 15% of cases fall into two groups: 

·         Nonstructural (functional): This type of scoliosis is a temporary condition when the spine is otherwise normal. The curvature occurs as the result of another problem. Examples include one leg being shorter than another from muscle spasms or from appendicitis. 

·         Structural: In this type of scoliosis, the spine is not normal. The curvature is caused by another disease process such as a birth defect, muscular dystrophy,metabolic diseases, connective tissue disorders, or Marfan's syndrome.

Scoliosis Symptoms

These symptoms are only those associated with the spine being curved:

·         Your head may be off center. 

·         One hip or shoulder may be higher than the other. 

·         You may walk with a rolling gait. 

·         The opposite sides of the body may not appear level. 

·         You may experience back pain or tire easily during activities that require excessive trunk (chest and belly) movement.

 

 

When to Seek Medical Care

Scoliosis usually occurs around age 10 years. Most school systems have screening programs that look for scoliosis. The most common test is to have the child stand with his or her feet straight ahead and with knees locked and then slowly bend over to touch their toes. If the school notifies you that they are concerned, you should contact your doctor to make a routine appointment within the next one to two months.

If your doctor (or pediatrician) examines your child and is suspicious, the doctor may repeat the exam in four to six months to see if there is any change. Most children do not need to be treated for scoliosis when the curvature is mild.

Scoliosis Treatment

The majority of cases of scoliosis do not require treatment. 

·         If the curve is less than 25°, no treatment is required, and the child can be reexamined every four to six months. 

·         If the curve is more then 25° but less than 30°, a back brace may be used for treatment. 

·         Curves more than 45° will need to be evaluated for the possibility of surgical correction. Surgical correction involves fusing vertebrae together to correct the curvature and may require inserting rods next to the spine to reinforce the surgery. 

·         Treatment options depend more on how likely it is that the curve will worsen than on the angle of the curve itself. A child with a 20° curve and four more years of growth may require treatment while a child with 29° of curvature who has stopped growing may not require treatment.

Outlook

With early screening and detection, most children with scoliosis can be treated to prevent more curvature. They can lead normal lives and have the same life span as other healthy people. The prognosis depends more on why the scoliosis occurred. If it occurs because of another disease, the outcome is related to the other disease rather than to the scoliosis.