Scoliosis

Question 1

Scoliosis General facts

Answer 1

Greater than 10 degree deviation

Peak incidence is 12-14 years

More common in females than males

1/20 patients have a degree of scoliosis

Named for direction of convexity/ APEX
- sidebending and hypertonic muscle side is always opposite

Almost all scoliosis is type 1 somatic dysfunction”

Question 2

Dextroscoliosis

Answer 2

Sidebent left
Rotated right
Convened on the right

Most common in thoracic spine with increased space between ribs on right.

Question 3

Levoscoliosis

Answer 3

Sidebent right
Rotated left
Convex on the left

More common in the lumbar spine

Question 4

Cobbs angles

Answer 4

Used to determine severity of scoliosis

Draw line above most superiorly affected vertebrae and below the most inferiorly affected vertebrae.

Then dar perpendicular lines from these lines and you get the cobbs angle.

Question 5

Adams test

Answer 5

Physical test for scoliosis

Pt takes shirt off and places feet together

Pt bends forward at the waist with the physician behind testing for asymmetry

Question 6

Functional scoliosis

Answer 6

Reversible w/ OMT and is nonstructural

No bony abnormalities are present

Vertebrae are almost always sidebent, but hardly ever rotated

Tight Psoas syndrome is an example

Question 7

Structural scoliosis

Answer 7

No OMT and tends to have bony abnormalities

Can be progressive

Question 8

Most common type of scoliosis

Answer 8

Double major scoliosis

This is because the single C curve develops, remains untreated and the body compensates with developing a 2nd contralateral C curve

Question 9

Mild, moderate and severe descriptions w/ respect to degrees

Answer 9

Mild = 10-20

Moderate = 20-50
- at this point and on requires a brace

Severe = >50

Question 10

Most common scoliosis braces

Answer 10

TLSO (lower thoracic and lumbar only)
- also called boston brace

Milwaukee (upper thoracic only )

Question 11

Etiology of scoliosis

Answer 11

Cerebral palsy

Myelomeningocele

Muscular dystrophy

80% is idiopathic

Question 12

Common syndromes with scoliosis

Answer 12

Kilppel feil

Marfans

Prayer wili

Ehlors danlos

Neurofibromatosis

Osteogenesis imperfecta

Question 13

Acquired etiology examples

Answer 13

Trauma

Psoas spasm

Osteomalacia

Arthroplasty in knee or hip

Question 14

When can scoliosis be treated with OMT?

Answer 14

When it is mild (>10 degrees)

Question 15

Types of congenital scoliosis

Answer 15

Wedge: partial unilateral failure of formation

Congenital bar: unilateral failure of segmentation

Hemivertebra: Complete unilateral failure of formation

Block vertebra: Bilateral failure of segmentation

Question 16

Muscle imbalance scoliosis

Answer 16

Concave side = hypertonic muscles

Convex side = overstretched muscles

The combination of these muscle developments cause pseudo scoliosis

Question 17

Respiratory and cardiovascular compromise in scoliosis

Answer 17

Respiratory compromise occurs when patient is >50 degrees

Cardiovascular compromise occurs when patient is >75 degrees