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Flashcards in Scoliosis/Short Leg Deck (19)
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1
Q

Define Scoliosis

A

a lateral curvature of the vertebral column

2
Q

describe classifications of scoliosis

A

Structural: does not correct with side-bending (irreversible)Functional: partially or completely straightened by sidebending opposite to the presenting curve (reversible)

3
Q

list osteopathic considerations in scoliosis

A
  • 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
Q

explain the use of Cobb angle measurements in scoliosis treatment

A

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
Q

discuss the benefits of using OMT on patients with scoliosis

A
  • 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
Q

explain biomechanics of short leg syndrome

A

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

7
Q

explain compensatory changes associated with short leg syndrome

A

Early compensation: Side bending, cephalad horizontal planes are typically depressed on side opposite the pelvic horizontal planeLate compensation: (Inequality > 10mm or 0.4 inches) S-shaped curve develops. Greater trochanteric planes depressed on the SAME side.

8
Q

explain guiding principles for progressive compensation in short leg syndrome

A
  • 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 compensateLumbosacral 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
Q

explain diagnostic difficulties in short leg syndrome

A

Clinical diagnosis based on structural findings alone is difficult and innacurate

10
Q

list diagnostic clues in short leg syndrome

A
  • 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
Q

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

A

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

12
Q

explain and apply guidelines for lift therapy in short leg syndrome

A

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
Q

list principles of lift therapy in short leg syndrome

A

14
Q

A scoliosis of 5 to 15 degrees is called what?

A

mild scoliosis

15
Q

A scoliosis of 20 to 45 degrees is called what?

A

moderate scoliosis

16
Q

A scoliosis of > 50 degrees is called what?

A

severe scoliosis

17
Q

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

A

> 50 degrees

18
Q

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

A

> 75 degrees

19
Q

What is the classical pattern for iliolumbar ligament syndrome?

A

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