Scoliosis Flashcards
3 dimensional deformity
1. frontal
2. transverse
3. sagittal
scoliosis
What plane do you see a Cobb angle >10
frontal plane
What plane do you see a trunk rotation >5
transverse plane
What plane do you see thoracic 30-35 or lumbar 50-60 angle
sagittal
Are all bony elements altered in scoliosis (Verteba. rib verticle angles, pedicles)
yes all elements are altered
due to bony abnormalities
-identified in utero
-often diagnosed in infant years
Failure of formation
Failure of segmentation
Congenital scoliosis
caused by disorders of the brain, spinal cord and muscular system
imbalance of trunk/spine muscles. poor muscle control, spacticity
thoracic and lumbar spine and pelvic obliquity
more severe and progressive, particularly in patients who are non-ambulatory
curves are usually not associated with pain
neuromuscular scoliosis
What are some additional associated diagnosis with neuromuscular scoliosis
cerebral palsy
spinal muscular atrophy
chiari malformation
SCI
connective tissue disorders
myopathic disorders
Diagnosed before age 10 and not due to congenial or neuromuscular etiologies
infantil scoliosis
juvenile scoliosis
Early onset scoliosis (idiopathic)
What does an xray assess with early onset scoliosis
assess the risk of progression
(cobb angle) (angle of trunk rotation) ( Rib vertebral angle)
Identified during pre/pubertal growth spurt age 10-18
adolescent idiopathic scoliosis
what is the most common type of scoliosis?
adolescent idiopathic scoliosis
true or false adolescent scoliosis is typically painfree but can be painful into adulthood
true
10-25 degree severity of cobb angle is classified as what?
mild
25-50 degree of severity of cobb angle is classified as what
moderate
> 50 degrees severity of cobb angle classified as what?
severe
scoliosis is named by the direction of ____ and location of the curves ____
named by the direction of convexity of curve and the location of curves apex in the spine
Right thoracic
right side convexity with an apex in the thoracic region of spine
How is the cobb angle measures on an Xray
Draw lines parallel to upper border of the upper vertebral body and lower border of vertebral body
Draw perpendicular lines from each of these lines and the angle between them is the angle of curvature
How is the angle of rotation measured?
graded 0-4 based on how far the pedicle is from midline
what is the risser number?
radiological measurement based on ossification of iliac apophysis
When is the patient at the greatest risk of curve progression
pubertal growth spurt
the larger the cobb angle the ____ risk for curve progression
greater the risk
Do adults with untreated AIS have an increased risk of mortality or impact to other systems?
no unless their curve is greater than 90 degrees
is chronic back pain common in individuals with scoliosis?
yes
not related to size or location
usually does not interfere with ability to work
What does a PT exam look like for a patient with scoliosis
Static posture
dynamic: forward bend test– thoracic curve
scoliometer- type of inclinometer that objectively measures angle of trunk rotation
If >5 degrees asymmetry is noted with a scoliometer what should you do?
refer for imaging xray
When is casting used?
early onset or congenital scoliosis
aim to slow or prevent progression
When are braces used and why?
aimed to halt or minimize curve progression
more flexible curves
younger patients
How long must a brace be worn daily?
18-23 hours a day until skeletally mature
Can mobilization be utilized in a patient who has scoliosis
yes to increase flexibility mainly at the apex of the curve
What does breathing work do for an individual with scoliosis
corrective breathing can increase rib mobility, increase strength of diaphragm and intercostals
increase cardiovascular endurance
increase vital capacity
increase breathing function
Learn curve characteristics and how to achieve best possible 3D posture correction
improve mobility and postural stability
reduce pain
help avoid loss of correction after brace wear completed
goal of schroth therapy
