7- Scoliosis/Short Leg Syndrome (Sandhouse) Flashcards Preview

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Flashcards in 7- Scoliosis/Short Leg Syndrome (Sandhouse) Deck (19):
1

Define Scoliosis

a lateral curvature of the vertebral column

2

describe classifications of scoliosis

Structural: does not correct with side-bending (irreversible)

Functional: partially or completely straightened by sidebending opposite to the presenting curve (reversible)

3

list osteopathic considerations in scoliosis

- body compensatory curves form to keep body balanced and eyes balanced
- rotation accompanies lateral curve (rotates INTO convexity)
- ribs on convex side separate and move posterior (ribs on concave side more anterior and closer together)
- Disc narrows on concave side

4

explain the use of Cobb angle measurements in scoliosis treatment

10 degrees- follow every 4-6 months

Curve progresses >5 degrees - treat
Curves > 30 degrees = treat
Curves < 20 degrees in mature adult will not usually progress.

5

discuss the benefits of using OMT on patients with scoliosis

- Increase muscle balance on both sides of curve
- Optimize function of existing structures
- Remove any somatic dysfunction
- Stretch lumbosacral tissues
- Reduce the lumbosacral angle and strengthen psoas and abdominal muscles

6

explain biomechanics of short leg
syndrome

Sacral Base Unleveling (Most clinically relevant element)
- Innominates rotate to compensate
- pelvic rotation and side shift will occur

7

explain compensatory changes associated with short leg syndrome

Early compensation: Side bending, cephalad horizontal planes are typically depressed on side opposite the pelvic horizontal plane

Late compensation: (Inequality > 10mm or 0.4 inches) S-shaped curve develops. Greater trochanteric planes depressed on the SAME side.

8

explain guiding principles for progressive compensation in short leg syndrome

- Postural changes
- Lower back pain (Most common/bothersome complaint)
- Pelvis will side shift and rotate AWAY from side of sacral base declination
- Innominate rotates anteriorly on side of short leg/ posteriorly on side of long side [opposite rotation] to compensate
Lumbosacral angle increases 2-3 degrees
- Vetertebrae of most caudal scoliotic curve suually sidebend away from and rotate toward the side of sacral base declination

9

explain diagnostic difficulties in short leg syndrome

Clinical diagnosis based on structural findings alone is difficult and innacurate

10

list diagnostic clues in short leg syndrome

- Recurrent somatic dysfunction of the pelvis, spine, cranium, or myofascial structures
- soft tissue involvement
- tight abductors on one side and tight adductors on the controalateral side
- Iliolumbar ligament on the side of convexity becomes stressed
- Visceral somatic reflexes between T1 and L2

11

explain the role of OMT in the patient with short leg syndrome

Corrects any somatic dysfunction once the spine is mobile as possible standard standing postural xrays

12

explain and apply guidelines for lift therapy in short leg syndrome

Lift Therapy: The longer something has been around/compensated, the more slowly you add the lift.

For fragile patient, begin w/ 1/16" heel lift (up to +1/16" per two weeks)
Flexible patient: begin with 1/8" heel lift (up to +1/8" per two weeks)
Sudden loss of leg length: lift FULL amount that was lost (ex. fracture)

13

list principles of lift therapy in short leg syndrome

...

14

A scoliosis of 5 to 15 degrees is called what?

mild scoliosis

15

A scoliosis of 20 to 45 degrees is called what?

moderate scoliosis

16

A scoliosis of > 50 degrees is called what?

severe scoliosis

17

At what degree of scoliosis is there compromising of the respiratory/pulmonary function?

>50 degrees

18

At what degree of scoliosis is there compromising of the cardiovascular function?

>75 degrees

19

What is the classical pattern for iliolumbar ligament syndrome?

pain from the ligament, down the side of the tigth, into the mediolateral inguinal region