Spine & Hips

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Niamh's Journey

Observations

At about the age of 2 years old we noticed that Niamh had a very slight s shape curve in her upper spine when she was bent forwards. As she got older we could also see that she was developing a slight hunch over her right shoulder.

What is Scoliosis?

Scoliosis is a curving of the spine. Depending on the direction and severity of the curve and this condition can lead to other serious complications particularly reducing the capacity of the lungs and in very serious cases affecting the heart.
Pneumonias become more common and breathing becomes difficult as the rib cage presses into the lung space. It is also possible that some rotational scoliosis may affect the stomach in so far as it may cause the internal organs to move position.

How can it be Treated?

1. Limiting Progression of Curve

The most common way of point this is by fitting the child with a back brace which offers support from gravity and attempts to fix the child’s back in the correct position.

Due to the strength of some of Niamh's dystonic spasms the brace was not effective in limiting the progression of her curve. The progression of her scoliosis led to knock on problems with the twisting of her ribcage reducing the capacity of one of her lungs and shifting the position of her stomach and other internal organs

2. Surgical Intervention - Growth Rods & Spinal Fusion

As children get older, the problem of scoliosis gets more serious as the impact on the organs increases. Within our group some older children have opted for surgical correction of their curves which has proved an effective way of limiting the impact of side effects on their organs.

One child has had Vpter growth rods inserted either side of their spine, attached to the shoulder blades and pelvis. These rods are adjustable in height and the child will have a small operation every 6-12 months to lengthen the rods which in turn will lengthen and straighten their spine as they grow.
Post surgery the family had issues regarding feeds, limited urine output and learning how to move the child so as not to twist the rods out of place however 5 months later routine was back to normal and the child is reported to sit much straighter and be happier in himself.

What are Displaced/Windswept Hips?

When a child does not bare weight on their legs it is sometimes possible for the hip socket to form a shallow hole that may not be deep enough to hold the hip joint in place. Children with shallow hip sockets have an increased risk of hip dislocation which can be very painful.

Children particularly at risk are children who do not weight bear and children that spend a lot of time laying on their back with their legs either flat down or "windswept" across to one side. In this position, the top leg will have the tendency to dislocate.

Niamh's windswept direction was left which led inevitable to her right hip becoming dislocated.

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