Scoliosis and Kyposis

Posted by e-Medical PPT
SCOLIOSIS
A condition that involves complex lateral and rotational curvature of the spine.
Dextroscoliosis is a scoliosis with the convexity on the right side.
Levoscoliosis is a scoliosis with the convexity on the left side.

Classification
Postural Scoliosis
 The deformity is secondary or compensatory to some condition outside the spine; when the patient sits (thereby cancelling leg asymmetry), the curve disappears.
Conditions that lead to postural scoliosis :
Short leg
Pelvic tilt due to contracture of the hip
Local muscle spasm @ prolapsed lumbar disc

Structural Scoliosis
 It is always accompanied by bony abnormality or vertebral rotation. The deformity is fixed and does not disappear with change in posture.
 Secondary curves nearly always develop to counterbalance the primary  later,  they may become fixed too.

Idiopathic scoliosis 80%
Infantile <3yrs
Juvenile 4-9 yrs
Adolescent >10yrs (Most common)

Scoliosis due to known causes 20%
Osteopathic: due to Congenital vertebral anomalies. Rare but dangerously progressive
Neuropathic: due to asymmetrical muscle weakness (e.g. in cerebral palsy and Poliomyelitis)
Myopathic: seen in the rare muscular dystrophies
Neurofibromatosis: associated with severe deformity

Cobb’s Angle
     Measurement used for evaluation of curves in scoliosis on an AP radiographic projection of the spine. When assessing a curve, the apical vertebra is first identified, the end or transitional vertebra are then identified through the curve above and below.

The apical vertebra is most likely displaced and rotated vertebra with the least tilted end plate.
The end/transitional vertebra is most superior and inferior vertebra which are least displaced and rotated and have the maximally tilted end plate. A line is drawn along the superior end plate of the superior end vertebra and a second line drawn along the inferior end plate of the inferior end vertebra.

KYPHOSIS
Definition
 The term kyphosis is used to describe both;
 The normal (the gentle rounding of the dorsal spine) and
The abnormal (excessive dorsal curvature).
In the latter sense it signifies a well-recognized deformity which may be progressive

Postural kyphosis
It is common (‘round back’ or ‘drooping shoulders’) and may be associated with other postural defects such as flat-feet

Structural kyphosis
Is fixed and associated with changes in the shape of the vertebrae. It may occur in osteoporosis of the spine (the commonly round back of elderly people), in ankylosing spondylitis and in scheuermann’s disease (adolescent kyphosis)

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