Chapter 5 - Scoliosis & Short Leg Flashcards
Scoliosis
lateral deviation of the spine
What % of school-aged children develop scoliosis by 15yo?
5%
What % of children w/ scoliosis have clinical Sx?
10%
Female:Male ratio of children w/ scoliosis
4:1
Scoliotic curve SB right - Naming?
Levoscoliosis
Scoliotic curve SB left - Naming?
Dextroscoliosis
Structural curve
fixed curve d/t vertebral wedging & shortened ligaments & muscles on the concave side
Functional curve
flexible, partially or completely corrected w/ SB to opposite side
Screening for scoliosis is recommended for
10-15yo
Cobb Method of measuring
Draw horizontal lines from vertebral bodies of extreme ends of curves + draw perpendicular lines from the horizontals + measure acute angle
Mild Scoliosis
Cobb angle = 5-15
Moderate Scoliosis
Cobb angle = 20-45
Severe Scoliosis
Cobb angle = >50
> 50 degree Cobb angle may compromise
respiratory function
> 75 degree Cobb angle may compromise
Cardiac function
80% of all scoliosis cases are caused by
idiopathic causes
Causes of scoliosis
idiopathic, congenital (malformation of spine), neuromuscular (muscle weakness, spasms), acquired (short leg syndrome, tumor, infection, sciatica, psoas syndrome)
Tx for Mild Scoliosis
conservative - Konstancin exercises & OMT to improve flexibility and strengthen trunk
Tx for Moderate Scoliosis
Mild Tx + Bracing
Tx for Severe Scoliosis
Surgery
Short Leg Syndrome
anatomical or functional leg length discrepancy –> sacral base unleveling, vertebral SB/R, innominate rotation
Anatomical leg length discrepancy
anatomically shorter
Most common cause of Anatomical leg length discrepancy
Hip replacement
Functional leg length discrepancy
one leg appears shorter
SD Findings w/ Short leg syndrome
sacral base lower on short leg side, anterior innominate on short leg side, posterior innominate on long leg side, lumbar spine SB away & R toward short leg, Lumbosacral angle increase 2-3, iliolumbar & SI ligament stress
Heel lifts are considered for femoral head discrepancies of >
5mm
Final lift should be __________ of the measured leg discrepancy
1/2-3/4
Fragile (elderly, arthritic, etc) pts should begin w/ a heel lift of
1/16” & increase 1/16” every 2 weeks
Flexible pts should begin w/ a heel lift of
1/8” & increase 1/8” every 2 weeks
Maximum heel lift inside shoe
1/4”
Maximum heel lift possible
1/2”
If a lift >1/2” is necessary, consider
ipsilateral anterior sole lift
