脊椎側彎大檢查 Scoliosis check up!
脊椎側彎好發於青少年，稱原發型脊椎側彎，常見於第二性徵發育時期（也就是第二生長爆發期）。根據過去的統計，女生較高比例有脊椎側彎。此時期脊椎容易塑形，若脊椎長期受不對稱的外力，則易使脊椎側彎程度加劇。現在大部分的人養成久坐的習慣，且長期處在於姿勢不良的狀態，脊椎側彎的案例越來越多。身為家長，應該要注意孩子有哪些姿勢上的歪斜，可以避免孩子脊椎側彎或儘速就醫防止側彎程度的惡化呢？
Scoliosis is a sideways curvature or rotation of the spine that occurs often during the growth spurt just before puberty. Statistics show that females are more likely than males to have scoliosis. The risk of worsening is higher if the bones are still growing. In addition, poor postures can put extra uneven stress on the spine, increasing the rate of spine malalignment. Parents should be aware of faulty postures or potential scoliosis signs of your child.
以下有六個部位可以觀察您的孩子
是否有脊椎側彎的傾向
There are 6 key points that parents can follow
頭頸歪斜 Tilted head & neck
慣用手的使用頻繁程度、寫字打字的姿勢等皆會影響頭頸歪斜的程度。通常是因胸椎側彎引起的頸椎代償。長期頭頸歪斜易演變頸部肌肉緊繃、頸椎僵硬、偏頭痛、脖子酸痛等問題。
Head and neck tilting is related to the frequently used dominant hand, writing and typing posture. Tilted neck and head is commonly a compensation of thoracic spine scoliosis. If not treated properly, neck and upper back pain problems may evolve in adulthood.
高低肩 Uneven shoulder height
高低肩與頭頸歪斜相似，皆是胸椎側彎引起的臨床表現。日常生活坐姿、寫字打字的姿勢、背書包的方式、容易聳肩的習慣等等皆會造成高低肩。高低肩姿勢者，進入成年後容易有肩頸或上背相關的痠痛。
Similar to tilted head and neck, uneven shoulder height is highly correlated with thoracic spine scoliosis. Uneven sitting, writing and typing postures can put stress on the spine. In addition, carrying a schoolbag on only one side or shrugging shoulders frequently can lead to uneven shoulder height. If not supervised properly, spine curvature may increase.
上背突出 Upper back protrusion
脊椎側彎較為嚴重者，常在平躺時感到背部某一側明顯的壓迫感或無法平貼於地。在外觀上，可觀察出單側的背部伴隨肩胛骨向後突出，若請孩子站著向前彎腰，則突出的程度會更為明顯。背部突出即胸椎側彎造成的表現，也伴隨肌肉的失衡與扭轉。核心肌群與腹部肌群無力也是此族群常見的問題。體適能一分鐘仰臥起坐測試，通常表現不佳。
In some cases, children may feel back unevenness while laying flat, with pressure on one side and hollowness on the other. Scapular or upper back protrusion may be noticed, with more evident during forward bending . Upper back protrusion is a result of thoracic spine scoliosis, followed by uneven muscle tone and strength with ribcage displacement. Therefore, core muscle and abdominal muscle weakness are common in this group.
脊椎僵直 Decreased spine mobility
胸椎與腰椎的脊椎側彎皆會造成背部的僵直。請孩子向前彎腰，並且從身體側邊觀察，可觀察出軀幹彎曲的程度減少。背部僵直的孩子通常柔軟度不佳，且偶爾伴隨腰部僵硬感。進入成年後，易有核心肌群無力、腰部酸痛、骨盆周圍酸痛等問題。
Decreased spine or trunk flexibility is common in those with scoliosis. Decreased normal spinal curvature can be observed during forward bending of the trunk. Children may feel low back stiffness or have difficulty in completing stretching routines. Core muscle weakness, low back pain and pelvic girdle pain may evolve in adulthood.
骨盆歪斜 Uneven hips
骨盆的歪斜需從站姿觀察，從孩子的後方可看到腰際線的歪斜，腰部兩側的曲線不對稱。骨盆的歪斜與坐姿不良有高度相關，習慣翹腳、斜坐一邊、三七步站姿等皆會影響歪斜程度。長期骨盆歪斜的族群易伴隨骨盆周圍肌肉無力、腰部不適、長短腳等問題。
Viewing from the back, parents can observe the height of both hips and curvature of the waist. There are many reasons for uneven hips. For example, crossing legs, sitting on one side and uneven standing. Therefore, faulty postures should be avoided at all times. Uneven hips is accompanied with pelvic and thigh muscle weakness, low back pain and leg length discrepancy.
長短腳 Leg length discrepancy
造成長短腳的原因很多，脊椎側彎是其中的一項。長短腳與骨盆歪斜密不可分，兩者會同時並行。長短腳孩子的家長需要多注意是否伴隨X型腿、扁平足、足部單側明顯外八等問題。發育中並且有長短腳的孩子需儘早接受矯正，避免成年後膝蓋、腳踝與腳底的疼痛。
Children with leg length discrepancy (or uneven leg length) have a higher chance of having uneven hips. Knock knees (knees falling inward), flat feet and everted feet are signs of uneven leg length, which can be observed during quiet standing. If there are signs of leg malalignment, it is recommended that the child receive early treatment or correction to prevent later knee or ankle problems.
脊椎側彎是3D的脊椎扭轉，進行矯正時需顧及到許多層面。在非開刀型介入當中，不論是徒手關節矯正、運動矯正或是穿著背架矯正皆需專業人員的評估與指導。
Scoliosis causes abnormal curvature of the spine in 3 dimensions. Lifestyle and postures during daily life varies from different individuals. Therefore, many aspects should be taken into account during spine correction. In order to receive the most suitable treatment, contact your doctor for further consultation and prescription.
若孩子符合以上的姿勢問題，早點尋求醫療協助，以免錯過矯正時機。
Early diagnosis is key, if your child have abnormal postures mentioned above, be sure to arrange check up.
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