4 Scoliosis

Question 1

What is th eepidemiology of scoliosis?

Answer 1

• curvatures <30 degrees will not prgress after child is skeletally mature

Question 2

What is idiopathic scoliosis?

Answer 2

• Genetic scoliosis 80% of all case disorders
• Classiified into
  
  • infantile (2month - 3 years)
  • juvenile (3-10 years)
  • Adolescent > 10yr
    
    • most common in US

Early onset = prior to age 5

high risk of progression

Question 3

What is the T1-S1 growth velocity for idiopathic scoliosis

Answer 3

• 0 - 5years old 2.2cm/year
• 5-10 years old 1cm/year
• puberty 1.8cm/year

Question 4

What are the classifications of idiopathic scoliosis?

Answer 4

• Failure of formation
  
  • Hemivertebra
• Partial failure of formation
  
  • wedge vertebrae
• Failure of segmentation
  
  • unilateral bar
  • block vertebra
    *

Question 5

What is the Cobb angle?

Answer 5

• formed by the inclination of the upper end plate of the upper end of the vertebra and the inclination of the lower end plte of the lower end vertebra
• Greater the angle, the more serious the diease
• Boys = girls
  *

Question 6

What are the pronosis and signs for each stage of idiopathic scoliosis?

Answer 6

• Infant: age 3 (spontanous healing/surgery)
• Juvenile age 3-10 (poor prognosis: growth rate of skeletal)
• Adolescent: Age 10-20
  
  • Convex to R Girls > boys
    
    • Convexity related to handedness)
• Adult 20+
  
  • Spinal and joint degeneration
  • increase in pain

Question 7

What degrees are considered for mild, moderate, and sever scholiosis?

Answer 7

• Mild = 10 - 25. 4:1
• Moderate = 25-50. 7:1
• Sever = >50. 10:1

Question 8

What is the mechanical process for adolescent idiopathic scoliosis?

Answer 8

• Torsion with eccentric loading of te spine and vertebral growth modulation

Mechcanotransduction

Question 9

What is vertebral and muscular Progressive Torsion?

Answer 9

Vertebral:

• Vertebral rotation / torsion
• Gibbus deformity (hump in spine)
• Kypho-scoliosis (sagittal/kyphotic curvature)

Muscles:

• Weakness
• Hypertorophy
• Muscle imbalance
• Trigger points

Question 10

What is the nuerological and visceral impacts of Progressive Tosion?

Answer 10

Neurological:

• Tone
• Spinal cord
• Neurdynamics

Visceral:

• Heart
• Lungs
• Other organs

Question 11

Describe the differnt curves in scoliosis and what has poor prognosis?

Answer 11

• Young ange
• Thoracic curve

Question 12

What are some medical guidelines for treating scoliosis?

Answer 12

• 20-50 degrees = brance
• > 50 = surgery

Question 13

What are the PT’s goals for scoliosis patients?

Answer 13

• Slowing progressive curvature
• maintain or improve fitness and lung capacity
• Observe curve changes
• Posture: self correction and stretches
• Treat symptpms
• Motor control
• Education (fear reduction)
• Brance use
• Adapting ADLs