Scoliosis is a problem with the spine where the spine is curved instead of straight, with the upper back being rounded and the lower back having a “swayback,” or inner curved problem, reports WebMD.

According to the Scoliosis Research Society, 85 percent of all scoliosis causes are idiopathic, meaning the cause is unknown. The remaining causes of scoliosis include birth defects, such as vertebrae that form abnormally before birth, and certain disorders such as cerebral palsy, Marfan’s syndrome, muscular dystrophy and Down syndrome. Infections and spinal fractures can also cause scoliosis.curvature of the spine during surgical correction of this condition. Screws and rods are placed in order to stabilize and straighten the spine.

What You Should Know About Adult Scoliosis

Scoliosis is defined as a curve of the spine of 10 degrees. Adult scoliosis is broadly defined as a curve in your spine of 10 degrees or greater in a person 18 years of age or older. Adult scoliosis is separated into 2 common categories:

• Adult Idiopathic Scoliosis patients have had scoliosis since childhood or as a teenager and have grown into adulthood.  We do not yet know the cause of idiopathic scoliosis, but there is a lot of genetic work going on in an attempt to answer this question.

• Adult “De Novo” or Degenerative Scoliosis develops in adulthood. Degenerative scoliosis develops as a result of disc degeneration. As the disc degenerates, it loses height. If one side of the disc degenerates more rapidly than the other, the disc begins to tilt. As it tilts, more pressure is placed on one side of your spine and gravity tends to cause the spine to bend and curve. The more discs that degenerate, the more the spine begins to curve.

Scoliosis is more common in girls than in boys, and the diagnosis is usually made after a child reaches 10 years of age. A doctor performs a physical examination and may take X-rays to definitively diagnose the disease. An X-ray tells if there is any growth left in the growth plates of the femur or humerus, and scoliosis can become worse if the patient has more growing to do, states MedicineNet. Serial X-rays are performed to track the changes of the spinal curve, which helps determine the best course of treatment.

Types of idiopathic scoliosis are categorized by both age at which the curve is detected and by the type and location of the curve.

When grouped by age, scoliosis usually is categorized into three age groups:

• Infantile scoliosis: from birth to 3 years old
• Juvenile scoliosis: from 3 to 9 years old
• Adolescent scoliosis: from 10 to 18 years old

This last category of scoliosis, adolescent scoliosis, occurs in children age 10 to 18 years old, and comprises approximately 80% of all cases of idiopathic scoliosis. This age range is when rapid growth typically occurs, which is why the detection of a curve at this stage should be monitored closely for progression as the child’s skeleton develops.

Terms Used to Describe Spinal Curvature

Scoliosis curves are often described based on the direction and location of the curve. Physicians have several detailed systems to classify specific curves, but here are some common terms used to describe scoliosis:

Terms that describe the direction of the curve:

• Dextroscoliosis describes a spinal curve to the right (“dextro” = right). Usually occurring in the thoracic spine, this is the most common type of curve. It can occur on its own (forming a “C” shape) or with another curve bending the opposite way in the lower spine (forming an “S”).

Severe scoliosis can lead to heart and lung problems if not treated, as the ribs press against the chest, making breathing more difficult, states Mayo Clinic. Adults who had scoliosis as a child may experience more back pain throughout their lives as compared to people without scoliosis.

Symptoms of scoliosis include an uneven waist, uneven shoulders, disjointed hip and a protruding shoulder blade, according to Mayo Clinic. The spine also curves or twists in acute cases, and the disease can cause one side of the ribs to protrude more than the other. Severe cases also induce labored breathing and back pain.

Diagnosis

Scoliosis can be recognized and diagnosed with a clinical exam, but xrays are necessary to fully evaluate the magnitude and type of scoliosis present. For a proper scoliosis evaluation, full length, whole spine xrays need to be performed. An MRI may also be recommended if there are symptoms of leg pain that may be associated with stenosis or if there is concern about possible spinal cord compression or abnormalities.

Treatment

The treatment of adult scoliosis is very individualized and based on the specific symptoms and age of the patient. Many patients have scoliosis and have very minor symptoms and live with it without treatment. Patients with predominant symptoms of back pain would typically be treated with physical therapy. Patients with back pain and leg pain may receive some benefit from injection treatment to help relieve the leg pain.  If lumbar stenosis (narrowing of the spinal canal) is present and is unresponsive to non-surgical treatment, then a decompression( removal of bone and ligaments pressing on the nerves) may be recommended. If the scoliosis is greater than 30 degrees, a fusion procedure will most likely be recommended along with the decompression. The fusion is recommended to prevent the curve from progressing when the spine is destabilized by the bone removal that is necessary to  decompress the nerves. Fusions are usually accompanied with metal rod and screw placement into the spine to help correct and stabilize the scoliosis and help the bone heal or fuse together. The length of the fusion, or the number of spine levels included, depends on the type of scoliosis and the area of the spine involved. The goal of adult scoliosis surgery is to first remove pressure on the nerves, and second to keep the scoliosis from progressing further.

“At every stage of life, men are encouraged to consider three equally important aspects of their health—physical health, mental health and social connection. Men’s Health Month in the United States is observed every June. This month aims to raise awareness of the same health concerns of Men’s Health Week but lasts the whole month. It is different from November, which is held in November and focuses on men’s mental health as well as prostate cancer. During the month of June, men are encouraged to set goals for their own health and wellness and begin to create a roadmap for achieving those goals.  This is for men to address medical or health problems that may be starting or already there or hopefully cleared as healthy and to continue yearly to make sure its cleared healthy or if not address before the issue gets severe.”

Lifespan / Miriam Hospital (https://www.lifespan.org/lifespan-living/importance-mens-health-month)

Men in this age range are encouraged to discuss the health concerns below with their doctors. These discussions can be part of a yearly annual wellness visit. While you may think you don’t need some of these tests, establishing a base line can be useful for continued health monitoring as you age, or as more acute health concerns arise.

• Physical exam: check blood pressure, screen for obesity and assess body composition (waist circumference). Testicular exam and testicular self-exam are important at this age.
• Metabolic screening: fasting blood sugar and fasting lipid profile based on risk and family history.
• Vaccines: influenza, COVID-19, Hepatitis A/B, HPV, Tdap and MMR should be considered.
• STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed.
• Assessment of risky behaviors: discuss any use of tobacco, alcohol, recreational drugs, anabolic steroids, as well as use of seatbelts and helmets and gun safety.
• Family planning: “pre-conception” counseling to educate men that adopting a healthy lifestyle—exercising, eating healthy foods, and avoiding substances—at an early age improves the chances of conceiving and having a healthy pregnancy and a healthy child.

Recommended screenings for adult men over 40

These screenings are similar to those recommended for younger men but start to look at health concerns that most often appear in middle age.

• Physical exam: check blood pressure, screen for obesity, measure body composition and consider prostate exam (in some cases).
• Metabolic screening: fasting blood sugar and fasting lipid profile and estimation of cardiovascular risk.
• Vaccines: influenza, covid-19, Hepatitis A/B, HPV (through age 45), Tdap and MMR. Shingles vaccine is recommended for adults over 50.
• STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed.
• Cardiovascular screening: based on risk and symptoms (may include stress testing or coronary artery calcium score).
• Cancer screening: based on family history and personal risks. May include prostate, colon and lung cancer screening as well as skin exam.
• Eye exam.

Recommended screenings for adult men over 65

Older men should continue to evaluate their health and make lifestyle changes based on conversations with their doctors to ensure they are able to live life to the fullest.

• Physical exam: blood pressure, height and weight, waist circumference and prostate exam.
• Metabolic screening: fasting blood sugar, fasting lipid profile, thyroid function (in some cases).
• Vaccines: influenza, covid-19, Hepatitis A/B, Tdap, Pneumovax/Prevnar and Shingles.
• STI screening: based on risk.
• Cardiovascular screening: abdominal ultrasound, coronary artery calcium score and stress testing based on risk and symptoms.
• Cancer screening: prostate, colon and lung as well as skin exam.
• Osteoporosis: screening should be considered in men over 70, men who lose height over time or have a low impact fracture. Fall risk assessment should be completed.
• Eye exam.

Mental health is an important determinant of overall health and quality of life at every age. Although men are more likely to suffer “deaths of despair” including alcoholism, overdose and suicide, they are far less likely than women to seek out mental health services. Undiagnosed and untreated mood disorders in young men are associated with impaired learning, risk-taking behaviors, use of substances and violence. Adult men with chronic diseases like diabetes and cardiovascular disease have worse outcomes when they also suffer from depression, and depression is associated with decreased longevity in older men.  Men are less likely to get treated than a women in screening or when signs or symptoms arise until they get in the way or regarding mental health do men make a move and help yourself since no one may do it for you.  Help yourself its June make a change for the best in your health!

“Cataracts affect more than 20.5 million Americans age 40 and older, and 6.1 million Americans have had cataract surgery.  Prevalence of Age Related Macular Degeneration-AMD increases with age. For people age 80 and older, approximately 3 in 10 Americans have early AMD and 1 in 10 have late AMD.”

American Academy of Ophthalmology (https://www.aao.org/newsroom/eye-health-statistics)

“June is Cataracts Awareness Month. As the year nears its midpoint, aging adults are advised to pause and learn more about a vision-worsening condition that occurs around age 40 when proteins in the eye lens begin to break down, clump and form a cloudy area over time. Cataracts affect 70 percent of adults by age 75, and recent CDC data* indicate more than 17% of adults above age 40 have a cataract in one or both eyes.

Risk factors linked to early development and quicker progression of cataracts include excessive sunlight exposure, smoking, and long-term use of steroid medication. Medical conditions linked to higher risk include diabetes, obesity, high blood pressure, and prior eye surgery or eye injuries. Aging adults should discuss their health behaviors and history with their eye specialist to evaluate risk for developing cataracts and other age-related eye diseases to prevent blindness.”

UNC school of medicine / school of medicine ophthalmology (https://www.med.unc.edu/ophth/2023/06/june-is-cataracts-awareness-month/)

“Actinic Keratosis a rough, scaly patches of skin that are considered precancerous and are due to sun exposure. Prevention is to cut sun exposure and wear sunscreen. Treatments include performing cryosurgery (freezing with liquid nitrogen), cutting the keratoses away, burning them, putting 5-fluorouracil on them, and using photodynamic therapy (injecting into the bloodstream a chemical that collects in actinic keratoses and makes them more sensitive to destruction by a specialized form of light).

Keratoacanthoma this is a harmless, hard nodule that appears on the skin, most commonly on the face or arm of elderly people. The nodule may grow to up to 2 centimeters in diameter over about 8 weeks before gradually disappearing. However, the unsightly nodule is often surgically removed. The cause of keratoacanthoma is unknown, although exposure to sunlight appears to be a factor.”

Medicine Net (https://www.medicinenet.com/image-collection/actinic_keratosis_solar_keratosis_picture/picture.htm)

“Most of the cells on the skin’s surface are flat, scale-like squamous cells. Squamous cell carcinomas are the second most common type of skin cancer, accounting for about 20 percent of all diagnoses. These cancers also are slowing growing, but squamous cell carcinomas can spread to lymph nodes and even internal organs. Research indicates that the metastasis rate of squamous cell carcinoma of the skin is less than 10 percent within two years of diagnosis.

More than 150 years ago, a German scientist named Friedrich Merkel documented what he identified as tastzellen, German for “touch cells.” They would later be named Merkel cells. These cells are found below the epidermis, where they interact with nerve cells and help the skin feel light touch, textures and fine details.

Merkel cell carcinomas may appear as bumps or nodules—often red in color—on sun-exposed skin. This is a rare cancer, but it is often aggressive and may metastasize.  About 2,000 to 3,000 cases of Merkel cell carcinoma are diagnosed in the United States every year, according to the American Cancer Society, and the numbers are on the rise. The disease is rarely diagnosed in patients under 50 years old and is mostly found in white men older than 70.”

Cancer Center/ City of Hope (https://www.cancercenter.com/community/blog/2023/10/skin-cells-merkel-basal-squamous#Q2)

“Your skin has three layers that house your sweat and oil glands, hair follicles, melanocytes, and blood vessels.

Skin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.

There are three major types of skin cancer — basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal cell carcinoma is a type of skin cancer. Basal cell carcinoma begins in the basal cells — a type of cell within the skin that produces new skin cells as old ones die off.

Melanoma is a kind of skin cancer that starts in the melanocytes. Melanocytes are cells that make the pigment that gives skin its color. The pigment is called melanin.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/skin-cancer/symptoms-causes/syc-20377605)

“National data from this program reveal that about 1 in 3 women and 1 in 50 men respond “yes,” that they experienced MST, when screened by their VA provider. Although rates of MST are higher among women, because there are many more men than women in the military, there are actually significant numbers of women and men seen in VA who have experienced MST. In fact, over 1 of every 3 Veterans who tell a provider they experienced MST are men.

It is important to keep in mind that these data speak only to the rate of MST among Veterans who have chosen to seek VA health care; they cannot be used to make an estimate of the actual rates of sexual assault and harassment experiences among all individuals serving in the U.S. Military since all do not speak out.

Like other forms of trauma, MST can be a life-changing event. However, people are often remarkably resilient after experiencing MST. MST is an experience, not a diagnosis or a mental health condition, and there are a variety of reactions that Veterans can have in response to MST. Many individuals recover without professional help. Others may generally function well in their lives but continue to experience some level of difficulties or have strong reactions in certain situations. For some Veterans, the experience of MST may continue to affect their mental and physical health in significant ways, even many years later.

Recognizing that many survivors of sexual trauma do not disclose their experiences unless asked directly, VA health care providers ask every Veteran whether they experienced MST. This is an important way of making sure Veterans know about the services available to them.”

U.S. Dept of Veteran Affairs (https://www.ptsd.va.gov/understand/types/sexual_trauma_military.asp)

“All children may experience very stressful events that affect how they think and feel. Most of the time, children recover quickly and well. However, sometimes children who experience severe stress, such as from an injury, from the death or threatened death of a close family member or friend, or from violence, will be affected long-term. The child could experience this trauma directly or could witness it happening to someone else. When children develop long term symptoms (longer than one month) from such stress, which are upsetting or interfere with their relationships and activities, they may be diagnosed with post-traumatic stress disorder (PTSD).

Because children who have experienced traumatic stress may seem restless, fidgety, or have trouble paying attention and staying organized, the symptoms of traumatic stress can be confused with symptoms of attention-deficit/hyperactivity disorder (ADHD).

Examples of events that could cause PTSD include

• Physical, sexual, or emotional maltreatment
• Being a victim or witness to violence or crime
• Serious illness or death of a close family member or friend
• Natural or manmade disasters
• Severe car accidents.”

U.S. Centers for Disease Control and Prevention (https://www.cdc.gov/childrensmentalhealth/ptsd.html)