Incorrect posture and spinal deformities among pupils in the USA

Causes 
There are significant efforts being made toward identifying the cause of AIS, but to date there are no well-accepted causes for this particular type of scoliosis. The vast majority of patients are otherwise healthy and have no previous medical history. There are many theories about the cause of AIS including hormonal imbalance, asymmetric growth and muscle imbalance. Approximately 30% of AIS patients have some family history of scoliosis, and therefore there seems to be a genetic connection. Many Scoliosis Research Society members are working to identify the genes that cause AIS, and this knowledge continues to expand at a rapid pace. Most likely, there will be many genes associated with scoliosis and each may be helpful in detecting scoliosis and determining the risk for progression of the curve.

Symptoms 
Adolescent idiopathic scoliosis generally does not result in pain or neurologic symptoms. The curve of the spine does not put pressure on organs, including the lung or heart, and symptoms such as shortness of breath are not seen with AIS. When scoliosis begins in adolescence patients often have some back pain, typically in the low back area. Although it is often associated with scoliosis, it is generally felt that the curvature does not result in pain. Low back pain is not uncommon in adolescences in general. Many teens experience back pain due to participating in a large number of activities without having good core abdominal and back strength, as well as flexibility of the hamstrings. Adolescent idiopathic scoliosis generally does not result in pain or neurologic problems. If these symptoms occur, further evaluation and testing may be necessary to include an MRI.

Treatment

Treatment of adolescent idiopathic scoliosis falls into three main categories: observation, bracing and surgery. The treatment recommended is based on the risk of curve progression. In general, AIS curves progress during the rapid growth period of the patient. While most curves slow their progression significantly at the time of skeletal maturity, some, especially curves greater than 60^o, continue to progress during adulthood.

Non-Operative Treatments

• Observation 
  Observation is generally for patients whose curves are less than 25-30º who are still growing, or for curves less than 45º in patients who have completed their growth. Scoliosis surgeons often wish to observe the scoliosis every few years after patients complete their growth to make sure it does not progress into adulthood.
• Alternative Treatment 
  Alternative treatments to prevent curve progression or prevent further curve progression such as chiropractic medicine, physical therapy, yoga, etc. have not demonstrated any scientific value in the treatment of scoliosis. However, these and other methods can be utilized if they provide some physical benefit to the patient such as core strengthening, symptom relief, etc. These should not, however, be utilized to formally treat the curvature in hopes of improving the scoliosis.

Surgical treatment

Surgical treatment is recommended for patients whose curves are greater than 45^o while still growing, or are continuing to progress greater than 45^o when growth stopped. The goal of surgical treatment is two-fold: first, to prevent curve progression and secondly to obtain some curve correction. Surgical treatment today utilizes metal implants that are attached to the spine, and then connected to a single rod or two rods. Implants are used to correct the spine and hold the spine in the corrected position until the instrumented segments fuse as one bone. The surgery can be performed from the back of the spine (posterior approach) (Figure S)through a straight incision along the midline of the back or through the front of the spine (anterior approach) (Figure T ). Although there are advantages and disadvantages to both approaches, the posterior approach is utilized most often in the treatment of AIS and can be utilized for all curve types. The anterior approach is an option when a single thoracic curve or a single lumbar curve is being treated. Many factors go into the decision as to the surgical approach and your doctor will review the options and choose the best approach for you.

Following surgical treatment, no external bracing or casts are used. The hospital stay is generally between 3 and 6 days. The patient can perform regular daily activities and generally returns to school in 3-4 weeks. Depending on the activities of the patient, full participation is allowed between 3 and 6 months after surgery. Most children will not need pain medications 10-14 days after surgery.

Conclusion

After the whole my research I’ve learnt a lot about posture, its structure, composition and functions and how many postural problems do pupils have in the USA. So, what can I conclude after my work? What are the main facts about the posture?

Posture is defined as the relative position or attitude of the body at any one period of time. One of the most important components of the posture is our spine and its position. Spine’s position has to be controlled by the person himself. In human anatomy spine is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. There are three regions of spine with mobility: cervical (7 vertebrae), thoracic (12 vertebrae) and lumbar (5 vertebrae), according to the regions they occupy. A typical vertebra consists of two essential parts: an anterior (front) segment, which is the vertebral body; and a posterior part – the vertebral (neural) arch – which encloses the vertebral foramen. Viewed laterally the normal spine presents several curves, which correspond to the different regions of the column.

Excellent posture can be obtained by regular exercise as stated above and by just being aware of the need for practicing good posture habits. What is good posture anyway and why is it so important? Basically posture refers to the body's alignment and positioning with respect to the ever-present force of gravity.

Our body contains over 600 muscles. All muscles support our posture and when some of these muscles become weak our natural posture position is in constant danger. Heavily impaired posture can become the main reason for the appearance of spinal deformities. For example: the most widespread – scoliosis. 

Everyone’s spine has natural curves. These curves round our shoulders and make our lower back curve slightly inward. But some people have spines that also curve from side to side, and rotate. Unlike poor posture, these curves can’t be corrected simply by learning to stand up straight.

This condition of side-to-side spinal curves is called “scoliosis”. On an x-ray, the spine of a person with scoliosis looks more like an “S” or a “C” than a straight line. These curves can make the person’s shoulders or waist appear uneven. Some of these bones may also be rotated slightly, making one shoulder blade more prominent than the other. Scoliosis can’t be cured yourself, because it’s very strong curvature and it can be corrected only by surgeons. 
 During my research I understood the whole importance of keeping natural posture and monitor its state. In my opinion, research in this area should continue, because we can name this problem as “the problem of the 21 century”.  I suppose that, the main thing in keeping our postures natural, is saving the right position during all days, so it’ll be very objectively to invent some beacon lights to remind pupils about keeping their position in accordance with the rules.  

Incorrect posture is becoming more and more widespread in the whole world not only in the U.S.A. Examined all the features and characteristics of postural habits of pupils in the U.S., we can conclude that the incidence depends on the economic level of the country, because incorrect posture is a result of a sedentary way of life. And is it possible for the United States, that this problem can be a major drawback in the development of new generations. It’s fair to say, that the problem with incorrect posture for the United States has become the most common problem for children in the 21st century.