KLIPPEL-FEIL SYNDROME

SYRINGOMYELIA AND SCOLIOSIS

KYPHOSCOLIOSIS IN NEUROFIBROMATOSIS

Disk Herniation in Children and Adolescents
Case History
This 17 year old white female was involved in an automobile accident. She presented with localized low back pain and was diagnosed with lumbar strain. Her pain increased despite maximum physical therapy.

MYELOLIPOMA This is a congenital condition. The child is born with a soft lump in the lumbar region, usually in the mid line and occasionally it extends to one side of the lumbar area. Cutaneous changes are sometimes seen in the form of a skin dimple. In most cases the child is born with normal neurological status, occasionally changes in the lower limbs are seen. This could be the form of hypoplastic leg or talipes. Copied from: http://www.health.adelaide.edu.au

Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment - SOSORT Consensus paper 2005 Hans-Rudolf Weiss , Stefano Negrini , Martha C Hawes , Manuel Rigo , Tomasz Kotwicki , Theodoros B Grivas and Toru Maruyama Scoliosis 2006, 1:6 doi:10.1186/1748-7161-1-6 Published 11 May 2006 Abstract (provisional) Background Based on a recognized need for research to examine the premise that nonsurgical approaches can be used effectively to treat signs and symptoms of scoliosis, a scientific society on scoliosis orthopaedic and rehabilitation treatment (SOSORT) was established in Barcelona in 2004. SOSORT has a primary goal of implementing multidisciplinary research to develop quantitative, objective data to address the role of conservative therapies in the treatment of scoliosis. This international working group of clinicians and scientists specializing in treatment of scoliosis met in Milan, Italy in January 2005. Methods As a baseline for developing a consensus for language and goals for proposed multicenter clinical studies, we developed questionnaires to examine current beliefs, before and after the meeting, regarding (1) the aims of physical exercises; (2) standards of treatment; and (3) the impact of such treatment performed by specialists in the field. Results The responses to the questionnaires show that, in principle, specialists in scoliosis physiotherapy do not disagree and that several features can be regarded, currently, as standard features in the rehabilitation of scoliosis patients. These features include autocorrection in 3D, training in ADL, stabilizing the corrected posture, and patient education. (full text available)

Clinical Clerkship Notes
Scoliosis is defined as a curvature of the spine greater than 10 degrees in the AP plane. It is more common and likely to progress in girls.
Contents Etiology, Clinical Assessment, Radiograph Evaluation, Complications, Treatment, Controversies

Definition Scoliosis means abnormal curvature of the spine. The curvature takes place in three dimensions. The normal spine is straight in the anterior-posterior direction, or when one looks at a person from front-back. The normal spine is curved in the lateral direction, or when one looks at a person from the side. There is a gentle kyphosis, or bending forward, of the thoracic spine, or the spine in the chest. There is a bending backward, or lordosis, of the lumbar spine, or the spine that is between the chest and the pelvis. In scoliosis, the normally straight spine in the front-back direction becomes S-shaped, and the normally curved spine in the side direction typically straightens out (Figure 1). In addition, the spine twists on its axis, pushing the ribs and flanks backward and forward to produce a prominence, or "hump" (Figure 2).

Presentation at Orthopaedic Grand Rounds, McMaster

Back Pain

LUMBOSACRAL AGENESIS

TORTICOLLIS CAUSED BY INTERVERTEBRAL DISC CALCIFICATION

Comprehensive overview including physical and radiologic examinations as well as surgical and non-surgical treatments.

Torticollis