Osteoporosis, Compression Fractures Hyper-kyphosis, and Scoliosis

Question 1

Who is osteoporosis of the spine usually seen in?

Answer 1

Typically seen post menopausal
Typically women > Men
Increases with age
The spine, femur and pelvis

Question 2

Score for osteoporosis?

Answer 2

t score of -2.5

Question 3

Osteopenia score?

Answer 3

-1 to -2.5

Question 4

Normal T-sore?

Answer 4

-1 and above

Question 5

Who should get a DXA (who is at risk for osteoporosis)?

Answer 5

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

Question 6

Osteoporosis Prevention

Answer 6

education 
dietary intake (calcium and vitamin D) fruits and vegetables
regular exercise
avoid smoking
2-3 drinks a day or less

Question 7

Osteoporosis Prevention Programs

Answer 7

Progress: seated, supine, prone,quadruped, standing

decrease kyphosis and compression fractures

Question 8

Compression Fractures

Answer 8

Compression fractures are wedge like fractures of the anterior part of the vertebral body this creates kyphotic posture
- associates with kyphosis

Question 9

Acute compression fracture

Answer 9

manual therapy is contraindicated

Question 10

Chronic healed compression fracture

Answer 10

relative contraindication for manual therapy

Question 11

Surgical intervention for treatment of compression:

Answer 11

Kyphoplasty or Vertebroplasty

Question 12

Exercise programs for compression fracture:

Answer 12

Back Extension exercises
Balance exercises
Impairment based interventions
- hip extension stretching/ mobs
-scapular strengthening
-pec major/minor stretching

Question 13

Gibbus or Hump Back:

Answer 13

sharp, posterior angulation. It is often structural due to wedging of the thoracic vertebrae

Question 14

Dowagers Hump

Answer 14

postmenopausal osteoporosis, anterior wedge fracture usually in the upper to middle T spine (also structural)

Question 15

Definition of Hyper-kyphosis

Answer 15

Kyphosis angel rated than 40 degrees

Question 16

Cobb’s Angle

Answer 16

T4-T12

Question 17

Debrunner

Answer 17

T2-3 interspace

T11-12 interspace

Question 18

Dowagers hump or gibbous deformity associates with:

Answer 18

Impairment mobility
Risk for falls
Risk of fractures
Shoulder pain/neck pain
An overall decline in function
Reduced pulmonic function

Question 19

Dowagers hump or gibbous deformity risks developing:

Answer 19

Vertebral fractures
Degenerative Disc Disease
muscle weakness
decreased mobility

Question 20

Treatment of Hyperkyphosis

Answer 20

Stretching: Pec, hip flexors
Strengthen: Back extensors, glutes, scapular muscles
Postural –Re-education: taping, scapular orientation
Bracing and taping

Question 21

Kyphosis: Schuermann’s disease

Answer 21

younger individuals 5-10% of the population
Defect of the vertebral body creating anterior wedging
Typically will have been with extension and rotation

Question 22

Schuermann’s disease treatment:

Answer 22

postural education, bracing, stretching of the anterior muscles and strengthening of the posterior spinal muscles.

Question 23

Right Thoracic Scoliosis

Answer 23

convexity is on the right Thoracic side)
Left shoulder appears lower
The hip is shifted to the left

Question 24

What degrees of scoliosis requires surgical consult?

Answer 24

50 degrees

Question 25

Rehabilitation Principles for patients with scoliosis

Answer 25

``` Stretch the concavity Strengthen the convexity Postural Awareness Deep Breathing Diaphragmatic breathing ```