FEATURE
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FEATURE
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Scoltech : Innovation in Scoliosis Diagnosis and Monitoring
By Shazia Anis CEO , BioSight Sdn Bhd
Assoc . Prof . Ir . Dr . Lai Khin Wee Deputy Dean ( Research ) Department of Biomedical Engineering Faculty of Engineering Universiti Malaya .
Scoliosis has a prevalence rate of 2.55 per cent in Malaysia and globally it affects 2-5 per cent of a country ’ s population . Scoliosis can be classified as idiopathic , congenital , neuromuscular or degenerative scoliosis . Idiopathic scoliosis is the diagnosis when all other causes are excluded and it comprises about 80 per cent of all cases . Idiopathic scoliosis is a spine deformity that mostly occur to a child during the growth spurt before puberty and has the tendency to progress severely during the puberty . Scoliosis can develop in infancy or early childhood . However , the primary age of onset for scoliosis is 10-15 years old , occurring equally among both genders . Females are eight times more likely to progress to a curve magnitude that requires treatment . Every year , scoliosis patients make more than 600,000 visits to private physician offices , an estimated 30,000 children are fitted with a brace and 38,000 patients undergo spinal fusion surgery ( National Scoliosis Foundation , June 2007 ).
Typical signs and symptoms related to scoliosis include uneven shoulders , tilted head ( not centred ), uneven waist & hips , protruded ribcage , body leaning on one side , etc . Close to 23 % of patients with idiopathic scoliosis experience the onset of symptoms with back pain . Upon further examination , 10 % of these patients were diagnosed with underlying associated conditions such as spondylolisthesis , syringomyelia , tethered cord , herniated disc or spinal tumour . The changes in the shape and size of the thorax may affect pulmonary function . Recent reports on pulmonary function testing in patients with mild to moderate idiopathic scoliosis showed diminished pulmonary function .
Scoliosis Research Society ( SRS ) defines scoliosis as a lateral curvature of the spine greater than 10 º as measured by the Cobb Angle on standing radiograph . The Cobb Angle helps the physicians to determine the type of treatment be given to a specific patient . A Cobb Angle that is
● greater than 10 º indicates the possibility of scoliosis [ 1 ];
● between from 10 º -25 º is categorised as mild scoliosis and is monitored periodically ;
● between 26 º to 40 º is moderate scoliosis ; and
● greater than 40 º is severe scoliosis that requires surgical interventions [ 2 ].
Curve progression is monitored by comparing the consecutive graphs taken . If the Cobb Angle is greater than or equal to 5 º, the curve is likely progressing [ 3 ]. Usually , patients with a progressing curve are fitted with a body brace to stop or reduce curve progression . In cases of severe curve progression , where bracing fails , corrective surgery is the alternative .
Patients with a progressing curve need more frequent x-rays taken compared to the other cases . However , physicians and experts are concerned about the frequent exposure and its
44 VOL 95 JULY-SEPTEMBER 2023