Kyphosis: Causes and Clinical Presentation

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Questions and Answers

Which of the following is a primary impairment related to a rounded back and protracted scapulae?

Pain

Weakness in the anterior muscles

Vision impairment

Forward head position (correct)

What secondary issue can arise due to forward head position?

Pain

Tight posterior muscles

Weakness in the posterior muscles

Vision impaired (correct)

Which activity is likely to be difficult secondarily to kyphosis?

Walking

Driving

Overhead activities (correct)

Reading

What is a potential effect on driving due to posture-related issues?

Impaired and/or restricted ability Signup and view all the answers

Which muscle groups are affected by tightness and weakness in this clinical presentation?

Tight anteriorly, weak posteriorly Signup and view all the answers

Which characteristic best differentiates a normal spine from a kyphotic spine?

A kyphotic spine has an exaggerated curve in the upper thoracic region. Signup and view all the answers

What is the primary region affected by kyphosis?

Upper thoracic region Signup and view all the answers

Which of the following is NOT depicted in the image showing kyphosis?

Exaggerated cervical curvature in a normal spine Signup and view all the answers

In the comparison of normal and kyphotic spines, which spine demonstrates a straight alignment?

Normal spine Signup and view all the answers

What is a primary contributor to increased thoracic posterior convexity?

Lengthened posterior longitudinal ligament Signup and view all the answers

Which spine condition is characterized by an exaggerated curve according to the image?

Kyphotic spine with an exaggerated upper thoracic curve Signup and view all the answers

Which condition is NOT mentioned as a contributing factor to kyphotic posture?

Shortened posterior longitudinal ligament Signup and view all the answers

What type of fracture is associated with anterior wedging leading to kyphotic posture?

Compression fracture Signup and view all the answers

What is one effect of stretched and weakened erector spinae muscles?

Increased thoracic posterior convexity Signup and view all the answers

Which structure, when lengthened, contributes to a rounded-back posture?

Posterior longitudinal ligament Signup and view all the answers

Which muscle group should be targeted to strengthen the scapular retractors?

Rhomboids Signup and view all the answers

Which of the following is a key component of conservative management for postural issues?

Postural education/training Signup and view all the answers

Which muscle is NOT typically strengthened as part of conservative management for weak areas?

Biceps brachii Signup and view all the answers

In conservative management, which muscles are typically stretched to address shortened tissues?

Pectoralis and anterior shoulder muscles Signup and view all the answers

What is an example of an educational aspect in conservative management?

Patient education Signup and view all the answers

Which of the following is a sign of scoliosis?

Uneven shoulders Signup and view all the answers

What characteristic is NOT typically associated with scoliosis?

Even hips Signup and view all the answers

A visible sign of scoliosis in a person's back includes:

Curve in spine Signup and view all the answers

Which of these symptoms would most likely suggest scoliosis?

Uneven hips Signup and view all the answers

In scoliosis, one common physical feature observed is:

Uneven shoulders Signup and view all the answers

What type of physical disfigurement is specifically noted during forward flexion in patients with scoliosis?

Rib hump on the convex side Signup and view all the answers

Which factor primarily determines the extent of activity limitations in individuals with scoliosis?

Severity of the curve Signup and view all the answers

Which activity may become particularly challenging due to the spine motions being uniformly limited in scoliosis patients?

Prolonged standing Signup and view all the answers

What additional health issue may develop as a result of a thoracic curve in scoliosis?

Impaired respiration Signup and view all the answers

Which clinical manifestation is indicative of scoliosis when bending forward?

Rib hump on the same side as convexity Signup and view all the answers

What is the primary purpose of bracing in conservative management?

To halt progression of the curve Signup and view all the answers

Which of the following statements is true about physical therapy (PT) in conservative management?

PT only helps to manage symptoms such as pain and weakness Signup and view all the answers

What is NOT a benefit of PT in the context of conservative management?

Halt progression of spinal curvature Signup and view all the answers

Which of these interventions is designed to halt the progression of spinal curvature?

Bracing Signup and view all the answers

Which symptom is NOT managed by physical therapy in conservative management?

Curvature correction Signup and view all the answers

Which characteristic uniquely identifies structural scoliosis?

It is characterized by a fixed rotation of the vertebrae Signup and view all the answers

What complication may arise due to structural scoliosis?

Decreased cardiopulmonary function Signup and view all the answers

Which condition can result in nonstructural scoliosis dissipating?

Changing body position Signup and view all the answers

What is a common cause of idiopathic scoliosis?

Unknown origin Signup and view all the answers

How is the severity of structural scoliosis assessed?

By the degree of vertebral convexity and curve from neutral Signup and view all the answers

What is the primary indication for surgery in severe spinal curvature cases?

Curves greater than 50-60 degrees Signup and view all the answers

Which of the following is the most common rod used in spinal fusion surgeries?

Harrington rods Signup and view all the answers

What is the typical sequence of treatments following spinal surgery for severe cases?

Bedrest, bracing, rehabilitation Signup and view all the answers

How much did the spinal curvature improve post-operation as shown in the x-ray images?

From 78 degrees to 15 degrees Signup and view all the answers

Which of the following best describes the nature of spinal fusion surgery for severe curvatures?

It is a major operation done in stages with a lengthy rehabilitation course Signup and view all the answers

Study Notes

Kyphosis

A curved spine, with the curve exaggerated in the upper thoracic region
Characterized by increased thoracic posterior convexity and rounded-back posture
May be caused by lengthened posterior longitudinal ligament, stretched and weakened erector spinae and rhomboids, or other neurological and postural syndromes
Compression fractures can cause anterior wedging, leading to kyphotic posture

Clinical Presentation of Kyphosis

Impairments: rounded back, protracted scapulae, forward head position, and impaired vision
Activity limitations: visual limitations, difficulty with overhead activities, and impaired driving

Conservative Management of Kyphosis

Stretching shortened tissues, such as pectoralis and anterior shoulder muscles
Strengthening weak areas, including scapular retractors and erector spinae
Patient education, postural education/training, and bracing

Scoliosis

Characterized by uneven shoulders, curves in the spine, and uneven hips
Lateral curvature of the cervical, thoracic, or lumbar spine, which can be idiopathic or caused by neuromuscular, degenerative, osteoporosis, traumatic, or postsurgical factors

Pathophysiology/Pathomechanics of Scoliosis

Structural scoliosis: irreversible lateral curve with fixed rotation of the vertebrae, convexity of the curve, and decreased cardiopulmonary function and neurologic signs
Nonstructural scoliosis: reversible lateral curve that dissipates with postural or positional changes

Clinical Presentation of Scoliosis

Impairments: back pain, disfigurement, and rib hump
Activity limitations: dependent on severity of curve, impaired respiration, limited spine motions, and difficulty with prolonged standing activities

Conservative Management of Scoliosis

PT for stretching, strengthening, and bracing to manage symptoms, but not to halt or correct curvature
Bracing designed to halt progression of curve, but not to change appearance cosmetically

Surgical Procedures for Scoliosis

Indicated for severe cases with curves greater than 50-60 degrees
Surgery involves a major operation, requires bedrest, bracing, and a lengthy rehabilitation course
Most common procedure uses rods, such as Harrington rods, and involves a full spinal fusion

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Description

Learn about the characteristics and causes of kyphosis, including the curved spine and rounded-back posture, as well as its clinical presentation and related impairments.