Scoliosis

What type of scoliosis is most prevalent?

80-85% are idiopathic.

What is a Milwaukee brace?

A full torso brace with a neck ring & rests for chin & back of head & wide bars in the front & back. **Risk for Noncompliance**

What is scoliosis?

A lateral or sideways spine curve shaped like an "S" or "C".

What are the risk factors of scoliosis?

Adolescents (9-15 yrs.), Females, Hereditary, Neuromuscular disorders.

In mild scoliosis, what is the degree of curvature?

Between 10-20 degrees.

In moderate scoliosis, what is the degree of curvature?

Between 20-40 degrees.

What are possible side effects of Methocarbamol?icity

CNS effects: confusion, depression, hallucinations. Other effects: ortho. hypotension, loss of spasticity & dizziness. May discolor urine.

Nash-Moe Method

Determines the degree of vertical rotation.

What other systems may be affected by severe scoliosis?

Heart & lung problems leading to dyspnea & pneumonia. Compression of nerves may lead to paralysis.

When is surgery indicated?

In a client with a cobb angle greater than 50 degrees & if bones have finished growing.

What are 4 types of idiopathic scoliosis?

Infantile, Juvenile, Adolescent, Adult.

What post-op instructions are given?

Limit activities for 6-8 weeks, no twisting or bending torso, deep infections can occur up to 8 yrs after surgery.

Adult Idiopathic scoliosis

May have been present in childhood or may have progressed with age. Neck is often involved & commonly have pain in back & down legs.

What is the difference between structural & non0structural scoliosis?

Non-structural the spine bends to compensate for bad posture, pain or tumors. The cause is alleviated to correct spine. Structural is more severe with deformities of bone in the spinal column.

Adolescent Idiopathic scoliosis

Occurs between 10-19 yrs; Most common type; Curve progression more common in females; Progression more common in younger kids with large curves than older kids with small curves.

Juvenile Idiopathic scoliosis

Occurs between 3-9 yrs; Usually progressive & requires surgery.

Infantile Idiopathic scoliosis

Occurs between birth-3 yrs; Usually left thoracic curvature; May resolve with age; More common in European males.

In severe scoliosis, what is the degree of curvature?

Over 40 degrees.

What is a rib hump?

Ribs on inside of the curve are compressed & ribs on the outside of the curve are spread apart. Can be seen in teh Adams test.

What is the most common curve pattern in scoliosis?

Right thoracic curve.

What is Methocarbamol & why may it be prescribed?

Roxabin an antispasmodic that acts in CNS to decrease muscle activity.

What are possible s/sx of scoliosis?

Spinal curve to 1 side, uneven hips or shoulders, different leg lengths, prominent shoulder blade, rib hump & sometimes back pain.

What is the most common type of brace used?

TLSO brace which is used before & after surgery.

What is the #1 Diagnostic test used?

X-ray using the cobb method to draw lines from end vertebrae of curve in order to estimate the degree.