SCOLIOSIS

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SCOLIOSIS
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• Scoliosis lateral (side-to-side) curve of the
  spine.

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• Structural - usually combined with a rotation of
  the vertebrae.
• Non structural scoliotic poor posture

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• Scoliosis may develop
• In the whole spine (total scoliosis)
• Only in one part of the spine (partial scoliosis)

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• Scoliosis may be
• Simplex
• Duplex
• Triplex
• with the primary and compensatory
  curves

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TYPES OF SCOLIOSIS

1. IDIOPATHIC the cause is unknown.
2. NEUROMUSCULAR is due to loss of control of the
   nerves or muscles that support the spine. The
   most common causes of this type of scoliosis are
   cerebral palsy and muscular dystrophy.
3. DEGENERATIVE may be caused by breaking down of
   the discs that separate the vertebrae or by
   arthritis in the joints that link them.
4. CONGENITAL due to abnormal formation of the
   bones of the spine and is often associated with
   other organ defects.

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IDIOPATHIC SCOLIOSIS

• INFANTILE Curvature appears before age three.
• JUVENILE Curvature appears between ages three
  and ten.
• ADOLESCENT Curvature usually appears between
  ages of ten and 13, near the beginning of
  puberty.
• ADULT - Curvature begins after physical
  maturation is completed.

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SIMPTOMS

• Lateral deviation of the spine

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- SIMPTOMS
2. Longitudinal rotation of the
vertebrae (torsion procesus spinosus rotates
toward the concavity, while the body of the
vertebrae rotates toward the convexity). The
body of the vertebrae are wedged on the side of
the concavity.
The spine changes its shape and way of
functioning.
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- SIMPTOMS

1. When the vertebrae rotates, the ribs also
   rotates, therefore we find a rib hump.

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- SIMPTOMS
4. The intercostal space is reduced on the concav
side (ribs are getting closer). 5. The
intervertebral space is narrower on the concav
side, and wider on the convex side.
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- SIMPTOMS
6. The vertebral canal is narrower on the convex
side.
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- SIMPTOMS
7. Constriction of the vertebrae (the wedge of
the vertebrae is situated on the concav side the
bigger wedge is located in the apex of the
deformation).
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• The apical vertebra in a curve, the vertebra
  most deviated laterally from the vertical axis
  that passes through the patient's sacrum, i.e.
  from the central sacral line

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EXAMINATION
Lowered shoulder
Lowered shoulder blade
Curvature of the spine
Inequality of the Lorents triangle
Lowered pelvis
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The scoliosis is determined according to the
convex side.
LEFT SCOLIOSIS
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• Scoliosis thoracalis dextroconvexa
• Scoliosis thoracalis dextra
• Cervical
• Cervicotoracal
• Toracal
• Toracolumbar
• Lumbar
• Lumbosacral

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METHODS TO DETERMINE THE DEGREE OF THE CURVATURE

• Based on an X ray of the spine
• Cobb method
• Raiser Ferguson method

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• THE COBB METHOD

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• With these methods we determine the degree of the
  curvature accordint to which we clissify the
  curvature into seven groups of scoliosis

GROUP DEGREE OF FLEXION
1. 0 - 20
2. 21 - 30
3. 31 - 50
4. 51 - 75
5. 76 - 100
6. 101 - 125
7. 126 and more
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• THE PROGNOSIS DEPENDS ON
• Type
• Location
• Etiology
• Age

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TREATEMENT

• 1. CONSERVATIVE
• KINESITHERAPY
• PASSIVE CORRECTION
• 2. OPERATIVE (surgery)

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BRACES
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EDF PRINCIPLE

• Elongation The brace elongates the trunk by
  lowering the pelvis and elevating the head.
• The rails get narrower on the convex side, and
  larger on the concave side.
• Derotation Derotation of the rotated vertebrae
  toward the normal position by doing some pressure
  on the rib hump.
• Flexion (lateral) flexion of the spine toward
  the convex side.

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• PHYSICAL EDUCATION CLASSES
• Untill 30 degrees normal PE classes
• Over 30 degrees - braces
• Over 50 degrees - surgery