scoliosis...structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital...
TRANSCRIPT
![Page 1: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/1.jpg)
Scoliosis
![Page 2: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/2.jpg)
Scoliosis
- an abnormal curvature of the spine in frontal plane
![Page 3: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/3.jpg)
Classification
1. Nonstructural scoliosis
2. Transient structural scoliosis
3. Structural scoliosis
1. Congenital
2. Idiopathic
3. Neuromuscular
4. Neurofibromatosis
5. Secondary
![Page 4: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/4.jpg)
lateral bending films to differentiate structural from nonstructural curves
![Page 5: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/5.jpg)
Nonstructural scoliosis
• postural scoliosis
• compensatory scoliosis
Transient structural scoliosis
• sciatic scoliosis
• hysterical scoliosis
• inflammatory scoliosis
![Page 6: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/6.jpg)
Structural scoliosis
• idiopathic (70 - 80 % of all cases)
• congenital
• neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita, Friedreich's ataxia)
• neurofibromatosis
• mesenchymal disorders (Marfan's syndrome, rheumatoid arthritis, osteogenesis imperfecta)
• trauma (fractures, irradiation, surgery)
![Page 7: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/7.jpg)
Structural scoliosis
• idiopathic (70 - 80 % of all cases)
• congenital
• neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita, Friedreich's ataxia)
• neurofibromatosis
• mesenchymal disorders (Marfan's syndrome, rheumatoid arthritis, osteogenesis imperfecta)
• trauma (fractures, irradiation, surgery)
![Page 8: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/8.jpg)
Idiopathic scoliosis:
female predilection 3(7) : 1
infantile, juvenile and adolescent
rotation and torsion
non-structural structural
Infantile: < 3 years, spontaneous correction
observation < 20o
orthosis 20o
surgery 50o
![Page 9: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/9.jpg)
Juvenile: 3 years to puberty, low progression
observation < 20o
orthosis 20o and progression
surgery 40o
Idiopathic scoliosis:
![Page 10: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/10.jpg)
Adolescent: puberty to skeletal maturity,
consider progression
observation 10o - 20o
orthosis 20o - 40o and progression
surgery 40o
Idiopathic scoliosis:
![Page 11: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/11.jpg)
• Medical and family history
• Observe the patient standing (front and back)
- abnormalities in the shoulders, rib cage, waist,
pelvis, legs (humpback, hip higher than the other, leg
length impariment)
diagnosis:
![Page 12: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/12.jpg)
diagnosis:
![Page 13: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/13.jpg)
diagnosis:
Adams forward-bending test
![Page 14: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/14.jpg)
diagnosis:
plumb line
![Page 15: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/15.jpg)
diagnosis:
![Page 16: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/16.jpg)
diagnosis:
long format
![Page 17: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/17.jpg)
end-vertebrae definition
Cobb´s angle
diagnosis:
![Page 18: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/18.jpg)
end-vertebrae definition
Cobb´s angle
diagnosis:
![Page 19: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/19.jpg)
Nash and Moe
diagnosis:
![Page 20: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/20.jpg)
determination of skeletal maturity
diagnosis:
![Page 21: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/21.jpg)
diagnosis:
determination of skeletal maturity
![Page 22: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/22.jpg)
treatment:
Conservative: growing spine - brace
(Milwaukee - CTLSO, Boston - TLSO)
![Page 23: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/23.jpg)
treatment:
surgical: posterior, anterior, combined,
correction of all components,
instrumentation, grafting,
light orthosis for 4 months
![Page 24: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/24.jpg)
treatment:
![Page 25: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/25.jpg)
treatment:
![Page 26: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/26.jpg)
treatment:
Scoliosis centres: Brno, Karviná
CZ 2011:
• Congenital 10
• Idiopathic 127
• Neuromuscular 22
• Neurofibromatosis 2
![Page 27: Scoliosis...Structural scoliosis • idiopathic (70 - 80 % of all cases) • congenital •neuromuscular (polio, cerebral palsy, syringomyelia, muscular dystrophy, amyotonia congenita,](https://reader036.vdocuments.net/reader036/viewer/2022071415/611160ec9572d62a56353533/html5/thumbnails/27.jpg)
Scoliosis (5)
M. Scheuermann (17)
Spondylosis, spondylathrosis (27)
Trauma C1 - 2
subaxial C (51)
T – L
Specific + non-specific inflammation (24, 26)