Pediatric Scoliosis OMT Module

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Pediatric Scoliosis OMT Module

• American College of Osteopathic Pediatricians
• Robert Hostoffer, DO,FACOP, FAAP

edited by Eric Hegybeli, DO, FACOP
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Background
Andrew Taylor Still, was born in Virginia in
1828, the son of a Methodist minister and
physician. At an early age, Still decided to
follow in his father's footsteps as a physician.
After studying medicine and serving an
apprenticeship under his father, Still became a
licensed M.D. in the state of Missouri. Later, in
the early 1860's, he completed additional
coursework at the College of Physicians and
Surgeons in Kansas City, Missouri. He went on to
serve as a surgeon in the Union Army during the
Civil War.
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Background

• After the Civil War and following the death of
  three of his children from spinal meningitis in
  1864, Still concluded that the orthodox medical
  practices of his day were frequently ineffective,
  and sometimes harmful. He devoted the next ten
  years of his life to studying the human body and
  finding better ways to treat disease.

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Background

• His research and clinical observations led him to
  believe that the musculoskeletal system played a
  vital role in health and disease and that the
  body contained all of the elements needed to
  maintain health, if properly stimulated. Still
  believed that by correcting problems in the
  body's structure, through the use of manual
  techniques now known as osteopathic manipulative
  treatment, the body's ability to function and to
  heal itself could be greatly improved. He also
  promoted the idea of preventive medicine and
  endorsed the philosophy that physicians should
  focus on treating the whole patient, rather than
  just the disease.
• http//www.aacom.org/OM/history.html

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Toddler and Children OMT
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Classification of Scolosis

• Nonstructural scoliosis
• postural scoliosis
• compensatory scoliosis

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Transient Structural Scoliosis

• sciatic scoliosis
• hysterical scoliosisgt
• inflammatory scoliosis

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Structural Scolosis

• idiopathic (70 - 80 of all cases)
• congenital
• neuromuscular
• poliomyelitis
• cerebral palsy
• syringomyelia
• muscular dystrophy
• amyotonia congenita
• Friedreich's ataxia
• neurofibromatosis
• mesenchymal disorders
• Marfan's syndrome
• Morquio's syndrome
• rheumatoid arthritis
• osteogenesis imperfecta
• certain dwarves
• trauma
• fractures

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Types of Curves
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Cobbs Angle
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Vertebral Maturation
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Maturation of iliac crest
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Osteopathic Considerations

• Type II (non-neutral) mechanics occur at the
  transitional areas between the spinal curves
• In scoliosis, flexed vertebral dysfunctions are
  typically found in the lumbar region extended
  dysfunctions in the thoracic region
• Scoliosis usually is not secondary to a short
  leg

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Osteopathic Considerations - Treatment

• Infantile scoliosis can be treated fairly
  effectively by addressing the occiput (usually
  with cranial), cervicothoracic and sacroiliac
  areas
• Treatment of older patients is focused on
  mobilizing restricted areas with OMT, stretching
  tightened tissues on the convex side,
  strengthening weak muscles on the concave side
  and correcting posture

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Shoulder Leveling
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Demonstrate the procedure on patient in front of
director
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Scapular leveling
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Demonstrate the procedure on patient in front of
director
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Pelvic Leveling
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Demonstrate the procedure on patient in front of
director
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Spinal Inspection
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Demonstrate the procedure on patient in front of
director
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Bending Test
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Demonstrate the procedure on patient in front of
director
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Innervation Table
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Print out the answer sheet to use with the
following questions.
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Circle the correct answer and review with
director

• Question1 A, B, C, D, E.
• Question2 A, B, C, D, E.
• Question3 A, B, C, D, E.

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Question

• 1. Inflammatory Scoliosis is considered a
• A. Transient scoliosis
• B. Structural
• C. Idiopathic
• D. Neurogenic
• E. NonStructural

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• 2. All of the following are causes of structural
  scoliosis except
• Wedge vertabrae
• Hemivertebrae
• Congenital Bar
• Block vertebra
• Circular wedge

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• 3. All are curves found in scoliosis except
• A. Thoracic curve
• B Cervico/thoracic curve
• C. Lumbar curve
• D. Double major curve
• E. Thoraco/lumbar curve

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Certificate of Completion

• I, _________________________, successfully
  completed the Pediatric OMT Module on __ __ 20__
• Signatures
• Pediatric Resident ____________________
• Pediatric Residency Director____________
• ( Please print and give to program director.)

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Congratulations