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Flashcards in Kyphosis Deck (8)
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1
Q

Kyphosis

A

abnormal posterior convexity

Normal kyphosis = 20-40d

May occur d/t trauma, congenital, scheuermann’s

May occur secondary to rx of spinal tumor rx with laminectomy

Common in pt’s with: OI, neurofibromatosis, myelomeningocele, spondyloeiphyseal dysplasia, rickets, osteochondrodystrophies

Not the same as postural round back

2
Q

Congenital Kyphosis

A

Anterior part of vertebrae is aplastic or hypoplastic and posterior elements are normal

Anterior unsegmented failure of formation or unsegmented bar leads to progressive kyphosis

M/c cause of spinal cord compression, may lead to paraplegia

Paraplegia often noted with progressive congenital kyphosis

Rx = surgery

Features: progression, cosmetic deformity, back pn, neuro deficit

3
Q

Scheuermann’s Disease

A

Rigid form of postural kyphosis
Develops during childhood and adolescence
M/c form of kyphosis in adolescence

Onset occurs just before puberty

Dx made via xray: irregular vertebral end plates, narrowing of disc space, anterior wedging of 5d or more for 3 continuous vertebrae, kyphosis greater than 40d that is uncorrected on active hyperextension

Schmorl’s nodes- disc protrusions inro spongiosa– may cause end plate irregularity

Occurs in thoracic spine

4
Q

Intervention Scheuermann’s Disease

A

Exercise:

  • active trunk extensor strengthening, general postural exercise, hamstring stretches
  • Recommend activities with trunk extensor component: volleyball, swimming, aerobic exercise

Orthotic Mgmt:

  • Kyphosis greater than 45-65d
  • Modified Milwaukee brace is used- worn for 22 hours for 12-18 mos, once skeletally mature used at night for maintenance
  • high success rate in skeletally immature pt’s
  • Milwaukee brace- 3 point dynamic system that promotes thoracic extension
  • determined a successful rx when vertebral bodies appear less wedge shaped

Surgical Mgmt:

  • Indicated when curve continues to progress despite use of orthotic, when curves > 65d, pnful degenerative changes
  • posterior fusion
5
Q

Postural Roudback

A

May be confused for Scheumermann’s

Roundback is not fixed

No end plate irregularity

Exercise = best intervention

Kyphosis greater than 60d patient may be rx with Milwaukee brace to prevent permanent structural changes

6
Q

PT Goals for Scheuermann’s

A

Improve postural alignment
Increase flexibility
Increase extensor strength

7
Q

Clinical Findings of Scheuermann’s

A

tight pects and hamstrings
increased thoracic kyphosis with a compensatory increased lumbar lordosis
forward head posture

Sometimes have associated scoliosis

8
Q

Congenital kyphoscoliosis or lordoscoliosis

A

result of combo of defective segmentation that occurs in more than one location