Flashcards in Scoliosis Deck (64):
What is the test that evaluates for scoliosis? What is assessed with this?
-Adam's forward bend test
-Assess rib prominence for rotation--will be opposite the side of the scoliosis
True or false: scoliosis usually has no symptoms
What are the s/sx of scoliosis when they occur?
What are the landmarks that should be palpated when evaluating scoliosis? (4)
What is the Cobb angle?
Angle between perpendicular lines drawn on the endplates (superior and inferior-most vertebrae) of the end vertebra
What degree of Cobb angle indicates scoliosis? Under this value dx = ?
10 degrees or more
Under = spinal asymmetry
What is the inter and intra observer reliability with Cobb angles?
How do we describe ("name") scoliosis?
Defined by the convexity
The location of scoliosis is defined by the vertebra that is (most/least) deviated, and called the apical vertebra
Levoscoliosis has a SD of what?
Sidebent right, rotated left
What is the difference between structural and functional scoliosis?
Structural = fixed, that will not correct with OMT
Functional = partially or completely treated with OMT
True or false: an uncorrected functional curve may progress into a functional curve
What are the four majors types of scoliosis? Which is the most common?
What causes congenital scoliosis?
Malformation of the vertebrae
What causes neuromuscular scoliosis?
Muscle weakness or spasticity (e.g. cerebral palsy, myelomeningocele, muscular dystrophy)
What causes acquired scoliosis?
What is the most common cause of scoliosis?
When does congenital scoliosis begin?
During the first 6 weeks in uterine life
True or false: congenital scoliosis is thought to be genetic
False--- caused by environmental factors
What are the 3 subcategories of idiopathic scoliosis? What defines each of these?
-Infantile- (0-3 yrs)
-Juvenile *(4-9 yrs)
-Adolescent (more than 10 yo)
What percent of AIS require treatment?
What is the F:M ratio of AIS?
Which is the more common type of AIS: right thoracic or left thoracic convexity?
What is a double major AIS?
Thoracic and lumbar bent if different directions
Name the type of scoliosis: caused by muscular weakness
Name the type of scoliosis: most often progressive
Name the type of scoliosis: Tumor or infx are examples of causes
Name the type of scoliosis: 80% of all cases of scoliosis
Are you more likely to progress with scoliosis if you have it when you're younger or older?
True or false: the larger the curve, the more likely to progress
True or false: double curves are less likely to progress
True or false: all else equal, males are more likely to progress
Curves measuring less than what degree at the end of growth, typically do not progress?
Curves measuring more than what degree at the end of growth typically progress?
What are the two major outcomes of AIS?
What are the mobility morbidities with scoliosis?
-Increased risk for falls, and asymmetric lower joints
True or false: there is a strong correlation between the emotional problems and the degree of curvature of the scoliosis
Does scoliosis increase the risk of LBP with preg?
Does being pregnant increase the risk of progression of scoliosis?
Is there an increased risk for C-section for pregnant women with scoliosis?
What is the relative mortality of pts with scoliosis relative to the general population
At what degree of scoliosis do breathing problems begin?
more than 70 degrees
What is the window of opportunity for surgical stabilization of scoliosis?
Progression of scoliosis may impair breathing so much that surgery is contraindicated, or will have increased mortality post surgery (Pneumonia etc)
Curves over what degrees decreases VC?
Curves over what degrees causes DOE?
Curves over what degrees causes alveolar hyperventilation, CO2 retention, pHTN, and right sided heart failure?
More than 100
When is bracing indicated for scoliosis?
-If still growing
-If scoliosis gets worse in 6 months or less
When is watchful waiting appropriate for scoliosis?
Still growing, but not severe enough for treatment
What defines mild, moderate, and severe scoliosis, in terms of cobb angles?
Mild = [10-20) degrees
Mod = [20-45]
Severe = more than 50
True or false: OMT is intended to completely straighten scoliosis
At what level (mild, mod, severe) should bracing be considered? Surgery?
Bracing = mod
When is scoliosis concerning?
Progression of the curvature during periods of rapid growth
Cobb angles between what degrees in 12-14 years indicates surgery? What about in any age?
More than 30 degrees in any age
Progression of the Cobb angle of more than how many degrees indicates surgical referral?
More than 5 degrees
When is ortho referral for scoliosis not indicated?
-Cobb angle less than 10
What is the role of exercise in the treatment of scoliosis?
Will not stem progression, but may help prevent degenerative changes, and reduce pain
What is the role of OMT in scoliosis?
Decrease pain, increase ROM and function
True or false: OMT can stem the progression of scoliosis
False-- only treats the symptoms
What are the three major causes of functional scoliotic curves?
-Focal muscle contraction
-Type II dysfunction
What are the three major steps in treating scoliosis with OMT?
-Treat the curve
-Treat transitional areas
-Treat spinal hypo-mobility
What should follow OMT treatments?
What are the 3 M's with bracing?
Braces are more effective if scoliosis is:
-spine is Mobile
-Spine not Matured
What are the four main focuses of treatment of scoliosis with OMT?