Scoliosis is the term used to describe any lateral curvature of the spine. Kyphosis is a curve in the upper back, commonly called roundback. Lordosis is a curve of the lower spine, commonly called swayback. Individuals can have any combination of curves, including a double scoliotic curve.
The spines of some polio survivors develop curvatures due to muscle weakness and paralysis. The higher the curve in the chest, the more likely breathing will be restricted along with a susceptibility to developing diastolic heart failure (Moe et al., 1978) (see Diastolic Heart Failure). Scoliosis also can cause neck and back pain; gastrointestinal, bowel, and bladder problems; mobility problems due to functional leg length differences, as well as problems with the use of the upper extremities (Clawson, 1998); and low self-image. The curvatures of polio survivors frequently progress as they age and as their muscles become weaker.
Prudent treatment decisions that correspond to an individual’s needs and preferences can be made after determining how scoliosis is affecting one’s health. Pulmonary function (see Pulmonary Function Tests) and blood gas tests and cardiac assessments, such as echocardiograms, should be performed regularly. Treatment options vary widely and include ventilatory support, bracing and seating to provide proper trunk support, and surgical spinal fusions (see Orthopedic Surgery).
Health care professionals need to understand the distinguishing characteristics of scoliosis resulting from polio such as intercostal paralysis (Moe et al., 1978). When considering surgical treatment, it is imperative that the orthopedic surgeon and anesthesiologist (see Anesthesia) have demonstrated evidence of successfully treating polio survivors (Bieniek, 1992).
Managing lifestyle factors such as weight, smoking, use of alcohol and medications, and activity level also are critical in reducing the problems associated with scoliosis. Alternative therapies (see Alternative Therapies) may help in reducing pain and in improving an overall sense of well-being (Bieniek, 1996).
References
Bieniek, L. (1992). Exploring your options. Polio Network News, 8(1), 1, 4-8.
Bieniek, L. (1996). Expanding our energy spheres and sources. Polio Network News, 12(4), 1-4.
Clawson, C. (1998). Scoliosis and seating. Polio Network News, 14(4), 1-2.
Moe, J., Winter, R., Bradford, D., & Lonstein, J. (1978). Scoliosis and other spinal deformities. Philadelphia, PA: W.B. Saunders Company.