Osteoporosis, Compression Fractures Hyper-kyphosis, and Scoliosis Flashcards
Who is osteoporosis of the spine usually seen in?
Typically seen post menopausal
Typically women > Men
Increases with age
The spine, femur and pelvis
Score for osteoporosis?
t score of -2.5
Osteopenia score?
-1 to -2.5
Normal T-sore?
-1 and above
Who should get a DXA (who is at risk for osteoporosis)?
women 65+
Low body weight
Cigarette smoking
Rheumatoid arthritis
History of non-traumatic fracture
Excessive alcohol consumption (3 or more services per day)
Diabetes, hyperthyroidism, menopause, chronic malnutrition or malabsorption
Osteoporosis Prevention
education dietary intake (calcium and vitamin D) fruits and vegetables regular exercise avoid smoking 2-3 drinks a day or less
Osteoporosis Prevention Programs
Progress: seated, supine, prone,quadruped, standing
decrease kyphosis and compression fractures
Compression Fractures
Compression fractures are wedge like fractures of the anterior part of the vertebral body this creates kyphotic posture
- associates with kyphosis
Acute compression fracture
manual therapy is contraindicated
Chronic healed compression fracture
relative contraindication for manual therapy
Surgical intervention for treatment of compression:
Kyphoplasty or Vertebroplasty
Exercise programs for compression fracture:
Back Extension exercises Balance exercises Impairment based interventions - hip extension stretching/ mobs -scapular strengthening -pec major/minor stretching
Gibbus or Hump Back:
sharp, posterior angulation. It is often structural due to wedging of the thoracic vertebrae
Dowagers Hump
postmenopausal osteoporosis, anterior wedge fracture usually in the upper to middle T spine (also structural)
Definition of Hyper-kyphosis
Kyphosis angel rated than 40 degrees
Cobb’s Angle
T4-T12
Debrunner
T2-3 interspace
T11-12 interspace
Dowagers hump or gibbous deformity associates with:
Impairment mobility Risk for falls Risk of fractures Shoulder pain/neck pain An overall decline in function Reduced pulmonic function
Dowagers hump or gibbous deformity risks developing:
Vertebral fractures
Degenerative Disc Disease
muscle weakness
decreased mobility
Treatment of Hyperkyphosis
Stretching: Pec, hip flexors
Strengthen: Back extensors, glutes, scapular muscles
Postural –Re-education: taping, scapular orientation
Bracing and taping
Kyphosis: Schuermann’s disease
younger individuals 5-10% of the population
Defect of the vertebral body creating anterior wedging
Typically will have been with extension and rotation
Schuermann’s disease treatment:
postural education, bracing, stretching of the anterior muscles and strengthening of the posterior spinal muscles.
Right Thoracic Scoliosis
convexity is on the right Thoracic side)
Left shoulder appears lower
The hip is shifted to the left
What degrees of scoliosis requires surgical consult?
50 degrees
Rehabilitation Principles for patients with scoliosis
Stretch the concavity Strengthen the convexity Postural Awareness Deep Breathing Diaphragmatic breathing