scoliosis for portfolyo.pptx

7/28/2019 Scoliosis for portfolyo.pptx

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SCOLIOSIS

MUHAMMED KOCABIYIK

PHYSICAL MEDICINE & REHABILITATIONIV. CLASS V. GROUP


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Scoliosis ?

from Greek: skolisismeaning

from skolios, "crooked twisted)a medical condition in which aperson's spine is curved from side to

side. Although it is a complex three-dimensional deformity, on an x-ray,viewed from the rear, the spine of an

individual with scoliosis may look morelike an "S" or a "C" than a straight line.
http://en.wikipedia.org/wiki/Romanization_of_Greekhttp://en.wikipedia.org/wiki/Romanization_of_Greek


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Scoliosis is a disorder that causesan abnormal curve of the spine, or

backbone. The spine has normalcurves when looking from the side,but it should appear straight whenlooking from the front. Kyphosisis a

curve seen from the side in which thespine is bent forward. Lordosisis acurve seen from the side in which the

spine is bent backward. People withscoliosis develop additional curves toeither side, and the bones of thespine twist on each other like a

corkscrew.
http://www.medicinenet.com/script/main/art.asp?articlekey=89177http://www.medicinenet.com/script/main/art.asp?articlekey=4198http://www.medicinenet.com/script/main/art.asp?articlekey=4198http://www.medicinenet.com/script/main/art.asp?articlekey=89177


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What causes Scoliosis?

In most cases, the cause of scoliosis isunknown (idiopathic). This type of scoliosisis described based on the age whenscoliosis develops.

Infantile Idiopathic Scoliosis -if theperson is less than 3 years oldJuvenile Idiopathic Scoliosis- developsbetween 3 and 10 years of age/onset ofpuberty

Adolescent Idiopathic Scoliosis- over10 years old or postpuberty ; mostcommon


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There are 3 other main types ofscoliosis:

Functional: the spine is normal, butan abnormal curve develops becauseof a problem somewhere else in thebody. This could be caused by one legbeing shorter than the other or bymuscle spasms in the back.Neuromuscular: there is a problem

when the bones of the spine areformed. Either the bones of thespine fail to form completely, or theyfail to separate from each other.


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This type of scoliosis develops in

people with other disordersincluding birth defects, musculardystrophy, cerebral palsy,or Marfan's disease. If the curve ispresent at birth, it is calledcongenital. This type of scoliosis isoften much more severe and needs

more aggressive treatment thanother forms of scoliosis.


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Degenerative: Unlike the other forms ofscoliosis that are found in children and teens,degenerative scoliosis occurs in older adults.Caused by changes in the spine due to arthritis.Weakening of the normal ligaments and othersoft tissues of the spine combined with

abnormal bone spurscan lead to an abnormalcurvature of the spine.Others: There are other potential causes ofscoliosis, including spine tumors such as osteoid

osteoma. This is a benign tumor that can occur inthe spine and cause pain. The pain causes peopleto lean to the opposite side to reduce theamount of pressure applied to the tumor.


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What are the symptoms ofscoliosis?

Most common symptom - abnormalcurve of the spine.

Scoliosis may cause the head to appear

off center or one hip or shoulder to behigher than the opposite side. If moresevere, it can make it more difficult forthe heart and lungs to work properly -

cause shortness of breathand chest painIn most cases, scoliosis is not painful,but there are certain types of scoliosisthan can cause back pain.


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How is scoliosis diagnosed?

Can use a medical and family history,physical exam, and tests when checkinga person for scoliosis. An x ray of the

spine can help the decide if a person hasscoliosis. The x ray lets the measure thecurve in degrees (such as 25 degrees)and see its location, shape, and pattern.

Also may request an MRI scan.


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The Cobb method

Choose the most tiltedvertabrae above and belowthe apex of the curve.

Draw a line perpendicular tothat vertabrae.

The angle created between

these intersecting lines isthe Cobb angle.


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Tests

Adams Bend Test


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How is scoliosis treated?

Treatment for scoliosis is basedon:

1. The person's age

2. How much more he or she islikely to grow

3. The degree and pattern of the

curve4. The type of scoliosis


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How is scoliosis treated?There are maincategories oftreatment: observation,physicaltherapy, bracing, and surgery

Functional scoliosisis caused by an

abnormality elsewhere in the body.this type of scoliosis is treatedby treating that abnormality,such as a difference in leg length

there is no direct treatment ofthe spine because the spine isnormal in these people


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Neuromuscular scoliosis is causedby an abnormal development of the

bones of the spine.have the greatest chance forgetting worse.observation and bracing do notnormally work wellMajority will eventually needsurgery to stop the curve fromgetting worse.


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Idiopathic scoliosis -based on theage when it develops

In many cases, infantile idiopathicscoliosis will improve without anytreatment. X-rays can be obtained

and measurements compared onfuture visits to determine if thecurve is getting worse.

Bracing is not normally effective

Juvenile idiopathic scoliosis -has thehighest risk for getting worse of all ofthe idiopathic types of scoliosis.


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Bracing can be tried early if the

curve is not very severe. The goal is to prevent the curvefrom getting worse until the

person stops growing. Since the curve starts early, andthey have a lot of time left to grow,there is a higher chance for needingmore aggressive treatment orsurgery.


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Adolescent idiopathic scoliosis - isthe most common form of scoliosis.

If the curve is small when firstdiagnosed, it can be observed andfollowed with routine X-rays andmeasurements. If the curve stays

below 25 degrees, no othertreatment is needed. If the curveis between 25-40 degrees, a bracemay be recommended. If the curveis greater than 40 degrees, thensurgerymay be recommended.


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Surgery:

1. to correct a curve or stop it from

getting worse when the person is stillgrowing

2. the curve is more than 45 degrees & thecurve is getting worse.

3. often involves fusing together two ormore bones in the spine, doctor may alsoput in a metal rod or other device. Thesedevices are called implants. They stay inthe body and help keep the spinestraight after surgery.


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Fusion

Most scoliosis operations involve fusing the vertebrae. Theinstruments and devices used to support the fusion vary.

In the fusion procedure, the surgeon will:Slice flaps to expose the backs of the vertebrae that lie alongthe curve.Remove the bony outgrowths along the vertebrae that allow the

spine to twist and bend.Lay matchstick-sized bone grafts vertically across the exposedsurface of each vertebra, being careful that they touch adjoiningvertebrae.Fold the flaps back to their original position, covering the bonegrafts.These grafts will regenerate, grow into the bone, and fuse thevertebrae together.


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This adolescent girl had a 50 curvaturetreated by thoracoscopic technique

resulting in excellent correction. Note thespontaneous correction of the un-operatedlumbar curvature. Also note the small, well-hidden incisions associated with theprocedure.


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About Other Treatments forScoliosis

So far, the following treatments havenot been shown to keep curves fromgetting worse in scoliosis:

Chiropractic treatment

Electrical stimulation

Nutritional supplementsExercise


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Indications for orthosesinclude the following:

1. Pain relief

2. Mechanical unloading

3. Scoliosis management

4. Spinal immobilization after surgery

5. Spinal immobilization after traumaticinjury

6. Compression fracture management7. Kinesthetic reminder to avoid certain

movements


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Contraindication for orthosis is:

Discomfort

Local pain

Osteopenia

Skin breakdown

Nerve compressionIngrown facial hair inmen

Muscle atrophy withprolonged use

Decreased pulmonary capacity

Increased energy expenditurewith ambulation

Difficulty with transfers

Psychological and physicaldependency

Increased segmental motion atthe ends of the Orthosis

Unsightly appearance

Poor patient compliance


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Scoliosis Orthosis, Boston Back Brace


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Lumbosacral Flexion-Extension ControlOrthosis (Chairback)


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TLS F-E-L Control Orthosis

(KnightTaylor)


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scoliosis is not typically associated

with back pain. In cases with backpain, the symptoms can be lessenedwith physical therapy, massage,exercises, yoga. These can help tostrengthen the muscles of the back.They are not, however, a cure forscoliosis and will not be able to

correct the abnormal curve.


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THE END

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scoliosis for portfolyo.pptx

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