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Common Spinal Deformities. Lordosis Excessive anterior curvature of the spine Exaggeration of normal curves in the cervical & lumbar spines. Common Spinal Deformities. Lordosis causes: Postural deformity Lax muscles (esp. abs) Heavy abdomen Compensatory mechanisms Hip flexion contracture
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Common Spinal Deformities • Lordosis • Excessive anterior curvature of the spine • Exaggeration of normal curves in the cervical & lumbar spines
Common Spinal Deformities • Lordosis causes: • Postural deformity • Lax muscles (esp. abs) • Heavy abdomen • Compensatory mechanisms • Hip flexion contracture • Spondylolisthesis • Congential problems • Fashion (high heels)
Common Spinal Deformities • Kyphosis • Excessive posterior curvature of the spine • Round back • Humpback/gibbus • Flat back • Dowager’s Hump
Scoliosis • Abnormal spinal curvature of various degrees or severity involving shortening of muscles and ligaments.
Common Spinal Deformities • Scoliosis • Nonstructural • “Functional” • May be related to leg length discrepancy • Structural • Lacks normal flexibility • Asymmetric movements
Common Spinal Deformities • Scoliosis • Ideopathic • Approx. 75-85% of all structural cases are ideopathic • Stretch concave curve • Strengthen convex curve
Patient History • History of injury? • Any previous back or neck pain? • Any positions of comfort? • Family history? • Previous illnesses, surgeries, or severe injuries? • Hx of other conditions (connective tissue diseases such as Marfan’s Syndrome)?
Marfan Syndrome? • Marfan syndrome is one of the more common disorders of connective tissue that can affect the Eyes, Skeleton, Lungs, Heart and Blood Vessels, and may be life-threatening. The effects of Marfan syndrome varies between individuals, some people only being mildly affected. • Marfan syndrome is a hereditary
Rehabilitation • Non surgical treatment + P.T . • Surgical treatment + P.T . • Stretched & strengthening technique . • Orthotics . • Hydrotherapy .
Scoliotic Curve • 0°- 30° Treated with signs of progression • 30°- 45° Orthotic Intervention • 45° < Surgical Intervention
TLSO Low Profile TLSO for Scoliosis • Worn when sleeping only • Made of semi-rigid plastic and foam Providence Orthosis Charleston Bending Orthosis
AIS • Types • Milwaukee • Effective • Self image • Boston brace • Not effective above T7 • Wilmington brace • Charlston brace part time at night 8 hrs
Treatment Demonstration:Charite Disc Replacement/Dextrorotatory Scoliosis • This is a case of L4 Charite Disc Replacement with and L5 Disc herniation and dextrorotatory scoliosis. • The Rule of 50% is discussed in relation to the treatment plan to relieve S1 dermatome pain.
Hyperkyphosis & Scheuermann's Disease treated in the supine position.
Hyperkyphosis / Scheuermann's Disease / Osteoporosis / Any Condition needing thoracic adjusting • Dr. Cox demonstrates flexion-distraction long-y-axis decompression spinal adjusting (low-velocity, low-amplitude adjusting) for any condition needing gentle thoracic spinal adjusting. Patients working on computers and carry much stress really appreciate this care.
Hyperkyphosis / Scheuermann's Disease / Upper Thoracic Spine Low-Velocity/Low-Amplitude (LVLA) Adjusting using the Cervical Headpiece • Highlights: • Use of the cervical spine restraint to treat the thoracic spine curvature. • Long Y axis automated distraction with cervical headpiece restraint in place. • Goals: • drop intradiscal pressures • increase foraminal area • restore physiological ranges of motion
Hyperkyphosis / Thoracic Spine Adjusting in the Side-Lying Position • For some patients, this very gentle application is preferred.
