Scoliosis Flashcards
1
Q
How is the scoliotic curve defined
A
- direction of convexity
- location
- magnitude via Cobb method
2
Q
What is a compensated scoliotic curve
A
- 1ºcurve is the major curve
- presence of secondary curves above or below so that shoulders will still be over pelvis
3
Q
What is a decompensated scoliotic curve
A
- no secondary curves = shoulders are not over pelvis
4
Q
What is a non-structural scolitic curve
A
- reversible and without rotation
- IE a true leg length causing scolitic curve
5
Q
What is a structural curve
A
- irreversible
- with rotation
- as the thoracic spine side bends you get some rotation
6
Q
What are the types of structural Scoliotic curves
A
- idiopathic = 85%
- osteopathic: altered bone structure
- neuropathic: hypertonicity on one side (such as in CP)
- Myopathic: muscle imbalance/altered muscle control
7
Q
Incidence of Adolescent idiopathic scoliosis
A
- 70-80% of all scolioses
- early onset (EOS) = < 10 years old
- Late onset (LOS) = > 10 y/o
- 2-3% of adolescent popultation (10% require intervention and 0.1% require surgery)
- Gender bias 7:1 female to male
8
Q
Evaluation of scoliosis
A
- posture assessment
- adams forward flexion: look posterior as they flex forward
- looking for a rib hump
- X-ray
9
Q
Risser Sign
A
- skeletal maturity
- ossification of iliac crest
- scale 0-5 5= skeletal maturity
- ASIS to PSIS (anterior to posterior)
- 0, 1, 2 highest risk of curve progression
10
Q
Treatment for scoliosis
for skeletally immature < 25º
A
- monitor
- exercises to stretch and strengthen
11
Q
Treatment for scoliosis
Skeletally immature 25º- 40º
A
- Bracing
- tria-c, Spinecore
- must be worn for at least 13 hours
12
Q
Treatment for scoliosis
skeletally immature >50º
A
- instrumented stabilization
- posterior spinal fusion with instrumentation and bone graft
- new techniques video assisted thoracoscpoic spinal fusion
13
Q
What is
Fusionless: vertebral body tethering
A
- Goes to the side of convexity
- not fusing segments
- rather tethering it together
- develop a more normal stress evenly on vertebral bodies so you dont get the wedging
14
Q
Goals for Treatment
for scoliosis
A
- prevent progression (correction bonus
- mostly just hold the progression
- minimize the wedging effect due to asymmetrical loading*
- due to wolfs law there are asymmetrical forcces being put onto the bone
15
Q
Exercise interventions for scoliosis
efficacy
A
- efficacy of exercise to halt scoliotic curvature progression remains debatable
- efficacy of exercise intervention appears related to specificity of the exercise meaning more specific= more effective
