scoliosis .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 anindividual with scoliosis may look more

like an "S" or a "C" than a straight line.
http://en.wikipedia.org/wiki/Romanization_of_Greekhttp://en.wikipedia.org/wiki/Romanization_of_Greekhttp://en.wikipedia.org/wiki/Romanization_of_Greek


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Scoliosis is a disorder that causes anabnormal curve of the spine, or backbone. Thespine has normal curves when looking from theside, but it should appear straight when lookingfrom the front. Kyphosisis a curve seen fromthe side in which the spine is bentforward. Lordosisis a curve seen from the sidein which the spine is bent backward. Peoplewith scoliosis develop additional curves toeither side, and the bones of the spine twist oneach other like a corkscrew.
http://www.medicinenet.com/script/main/art.asp?articlekey=89177http://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=4198http://www.medicinenet.com/script/main/art.asp?articlekey=89177http://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 scoliosis isdescribed based on the age when scoliosisdevelops.

Infantile Idiopathic Scoliosis -if the

person is less than 3 years oldJuvenile Idiopathic Scoliosis- developsbetween 3 and 10 years of age/onset ofpubertyAdolescent Idiopathic Scoliosis- over 10

years old or postpuberty ; most common


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There are 3 other main types of scoliosis:

Functional: the spine is normal, but an

abnormal curve develops because of a problemsomewhere else in the body. This could becaused by one leg being shorter than the otheror by muscle spasms in the back.

Neuromuscular: there is a problem when thebones of the spine are formed. Either thebones of the spine fail to form completely, orthey fail to separate from each other.


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This type of scoliosis develops inpeople with other disorders

including birth defects, musculardystrophy, cerebral palsy,or Marfan's disease. If the curve is

present at birth, it is calledcongenital. This type of scoliosis isoften much more severe and needsmore aggressive treatment than

other forms of scoliosis.
http://www.medicinenet.com/script/main/art.asp?articlekey=2007http://www.medicinenet.com/script/main/art.asp?articlekey=11682http://www.medicinenet.com/script/main/art.asp?articlekey=11682http://www.medicinenet.com/script/main/art.asp?articlekey=11682http://www.medicinenet.com/script/main/art.asp?articlekey=2007http://www.medicinenet.com/script/main/art.asp?articlekey=12154http://www.medicinenet.com/script/main/art.asp?articlekey=12154http://www.medicinenet.com/script/main/art.asp?articlekey=12154http://www.medicinenet.com/script/main/art.asp?articlekey=11682http://www.medicinenet.com/script/main/art.asp?articlekey=11682http://www.medicinenet.com/script/main/art.asp?articlekey=411http://www.medicinenet.com/script/main/art.asp?articlekey=411http://www.medicinenet.com/script/main/art.asp?articlekey=411http://www.medicinenet.com/script/main/art.asp?articlekey=12154http://www.medicinenet.com/script/main/art.asp?articlekey=411http://www.medicinenet.com/script/main/art.asp?articlekey=411http://www.medicinenet.com/script/main/art.asp?articlekey=411http://www.medicinenet.com/script/main/art.asp?articlekey=411http://www.medicinenet.com/script/main/art.asp?articlekey=12154http://www.medicinenet.com/script/main/art.asp?articlekey=11682http://www.medicinenet.com/script/main/art.asp?articlekey=11682http://www.medicinenet.com/script/main/art.asp?articlekey=2007


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Degenerative: Unlike the other forms of scoliosisthat are found in children and teens, degenerativescoliosis occurs in older adults. Caused by changes

in the spine due to arthritis. Weakening of thenormal ligaments and other soft tissues of thespine combined with abnormal bone spurscan leadto an abnormal curvature of the spine.

Others: There are other potential causes ofscoliosis, including spine tumors such as osteoidosteoma. This is a benign tumor that can occur inthe spine and cause pain. The pain causes people tolean to the opposite side to reduce the amount ofpressure applied to the tumor.
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WHAT ARE THE SYMPTOMS OFSCOLIOSIS?

Most common symptom - abnormal curve of thespine.

Scoliosis may cause the head to appear off center orone hip or shoulder to be higher than the oppositeside. If more severe, it can make it more difficult forthe heart and lungs to work properly - cause shortnessof breathand chest pain

In most cases, scoliosis is not painful, but there arecertain types of scoliosis than 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 tilted vertabraeabove and below the apex of thecurve.

Draw a line perpendicular to thatvertabrae.

The angle created betweenthese intersecting lines is the

Cobb angle.


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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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Neuromuscular scoliosis is caused

by an abnormal development of thebones 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 obtainedand measurements compared on

future visits to determine if thecurve is getting worse. Bracing is not normally effectiveJuvenile idiopathic scoliosis -has the

highest 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 curve from

getting worse until the person stopsgrowing.

Since the curve starts early, and theyhave a lot of time left to grow, there isa higher chance for needing moreaggressive treatment or surgery.


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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 curve

is 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 still growing2.the curve is more than 45 degrees & the

curve 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 spine straightafter surgery.


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This adolescent girl had a 50 curvaturetreated by thoracoscopic techniqueresulting 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 for

ScoliosisSo far, the following treatments havenot been shown to keep curves from

getting worse in scoliosis:Chiropractic treatmentElectrical stimulationNutritional supplementsExercise


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INDICATIONS FOR ORTHOSESINCLUDE THE FOLLOWING:

1. Pain relief2. Mechanical unloading3. Scoliosis management

4. Spinal immobilization after surgery5. Spinal immobilization after traumatic

injury

6. Compression fracture management7. Kinesthetic reminder to avoid certainmovements


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CONTRAINDICATION FOR ORTHOSIS IS:

Discomfort

Local pain

Osteopenia

Skin breakdown

Nerve compression

Ingrown facial hair in men

Muscle atrophy withprolonged use

Decreased pulmonary capacityIncreased 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 BACKBRACE


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LUMBOSACRAL FLEXION-EXTENSION

CONTROL ORTHOSIS (CHAIRBACK)


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TLS F-E-L CONTROL ORTHOSIS(KNIGHT-TAYLOR)


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scoliosis is not typically associatedwith back pain. In cases with back

pain, the symptoms canbe lessenedwithphysical therapy, massage,exercises, yoga. These can help to

strengthen the muscles of the back.They are not, however, a cure forscoliosis and will not be able tocorrect the abnormal curve.
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THE END

THANKS ALL

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