Scoliosis and Acute LBP Flashcards
Scoliosis is defined as…
lateral curve of the spine greater than 10 degrees
*generally idiopathic
Risk factors for scoliosis
- 2-4% of adolescents
- M=F for minor
- F»>M for major
Screening for scoliosis
- visual screen should always be done (but there is disagreement about this)
- Radiographs and treatment to confirm/fix can hurt children
*severe scoliosis should be associated with symptoms
What physical do you see with scoliosis?
- shoulder heigh difference, posterior scapula, cease at waist
- leg lengths are usually equal
- body adjust to get eyes equal levels
What is the Adam’s forward bend test?
pt stands and bends forward at the was it, and dr exams for asymmetry
What can be used to test degrees?
scoliometer
What is risser sign?
- tells you how mature/immature their skeleton is
- the higher the score, the less likely they will progress to become worse
Red flags of Scoliosis
- onset before age 8
- severe pain
- rapid crude progression >1 degree per month
- unusual left thoracic curve (right curve is more common)
- neurological deficits or findings
How do we deal with scoliosis curves less than 10-15 degrees? moderate with 25-45? severe greater than 45?
- no active treatment; can be monitored
- treated with bracing (though doesn’t prevent progression)
- requires surgery
How do we define acute LBP?
6-12 weeks of pain b/t the costal angles and gluteal folds that may radiate down one or both legs
*often non-specific, so can’t determine cause
What are serious red flags of acute LBP?
cancer, cauda equina, syndrome, fracture, infection
*
What are red flags for acute LBP?
T - trauma
U - unexplained weight loss
N - neurologic symptoms
A - age > 50
F - fever
I - IVDU
S - Steroid use
H - history of cancer
What are some common causes of LBP?
SD of LS spine, psoas syndrome, herniated nucleus pulposus, spinal stenosis, spondylolysis, spondylolisthesis
What causes psoas syndrome?
shortening/spasm of the iliopsoas m.
What causes caudal equine syndrome?
large central disc herniation compression the tail of the lumbar spine
*emergeny surgery is imperative –> if not done irreversible paralysis
