SPI NE PR O B LEM S

KYPHOSIS - LORDOSIS &

SCOLIOSIS
 Cervical
7 vertebrae
(C1 to C7)

Supports the head

THE SPINE and neck

Thoracic

IMPORTANCE Be t w e e
a
n
a
e
r e
ach
tiny
12 vertebrae
(T1 to T12)

Supports the ribs

verteb r
i s c s th at
d
cartilage
h ock
•Stability a c t a s s
s
ab s o rb er
•Protects Spinal Cord
Lumbar
•Protects Nerves 5 vertebrae

•Allows Movement
(L1 to L5)

Sacral
5 vertebrae
fused together
DID YOU KNOW? (S1 to S5)

The human spine is made up of 33 bones (vertebrae) that allow your Coccyx
body to bend, twist and stay upright. 4 vertebrae
fused together
 SPINE

KEEP IT HEALTHY!

•Stretching in Morning
•Eat Right
•Calcium!!
•Prevent Osteoporosis
•Work Out
•Increases Bone Density
 LET’S D ISC O VER !

KYPHOSIS
• (Greek - kyphos, a hump),
• also called round back or Kelso's hunchback,
• is a condition of over-curvature of the thoracic vertebrae
(upper back).
• It can be either the result of degenerative diseases (such as
arthritis), developmental problems, osteoporosis with
compression fractures of the vertebrae, and/or trauma.
• common during adolescence
 CAUSES
Underdevelopment/
Habitual Weakness of
Longitudinal Back

BAD Posture Muscle

Let’s practice correct posture! Stand up!

Injury/ Disease
Mental/
of Spine
Physical Rickets
Fatigue
Arthritis
 T Y PE S O F K Y P H O S IS

Postural Kyphosis Scheuermann's Kyphosis Congenital Kyphosis

 T Y PE S O F K Y P H O S IS

POSTURAL KYPHOSIS
• the most common type of kyphosis
• usually becomes noticeable during
adolescence
• more common in girls than boys
• rarely painful, and, because the curve
does not progress, it does not usually
lead to problems in adult life.
• noticed clinically as poor posture or
slouching but is not associated with
severe structural abnormalities of the
spine.
• The curve is typically round and smooth
and can often be corrected by the patient
when they are asked to stand up straight.
 T Y PE S O F K Y P H O S IS
SCHEUERMANN'S KYPHOSIS
• often becomes apparent during the teen
years.
• can result in a more severe deformity
than postural kyphosis.
• caused by a structural abnormality in
the spine
• The curve is usually sharp and angular.
It is also stiff and rigid.
• an X-ray from the side will show that, rather
than the normal rectangular shape, three or
more consecutive vertebrae have a more
triangular shape. This irregular shape causes
the vertebrae to wedge together toward the
front of the spine, decreasing the normal
disk space and creating an exaggerated
forward curvature in the upper back.
 T Y PE S O F K Y P H O S IS

SCHEUERMANN'S KYPHOSIS
• usually affects the thoracic spine but
occasionally develops in the lumbar
spine.
• more common in boys than girls and
stops progressing once growing is
complete.
• Sometimes painful
• Activity can make the pain worse, as
can long periods of standing or sitting.
 T Y PE S O F K Y P H O S IS

CONGENITAL KYPHOSIS
• present at birth.
• The bones may not form as they should, or
several vertebrae may be fused together.
• typically worsens as the child ages.
• Patients with congenital kyphosis often
need surgical treatment at a very young age
to stop progression of the curve.
 SY M PTO MS
The signs and symptoms of kyphosis vary, depending upon the
cause and severity of the curve.
These may include:
Rarely, over time, progressive curves
Rounded
shoulders may lead to:
A visible hump on the back
Weakness, numbness, or tingling in the
Mild back pain legs
Loss of sensation
Fatigue
Changes in bowel or bladder habits
Spine stiffness
Shortness of breath
Tight hamstrings
 DIAGNOSIS

PHYSICAL EXAMINATION

• Medical history asking about general health and

symptoms.
• They will then examine by pressing on the spine to
determine if there are any areas of tenderness.
• During the exam, the doctor will ask you to bend
forward with both feet together, knees straight, and
arms hanging free.
 DIAGNOSIS

PHYSICAL EXAMINATION
 DIAGNOSIS

XRAY
• X-rays provide images of dense
structures, such as bone.
• doctor may order X-rays from different
angles to determine if there are changes in
the vertebrae or any other bony
abnormalities.
• X-rays will also help measure the degree
of the kyphotic curve.
 DIAGNOSIS

PULMONARY FUNCTION
TESTS
• If the curve is severe, the doctor may order
pulmonary function tests.
• These tests will help determine if your
child's breathing is restricted because of
diminished chest space.
 DIAGNOSIS

OTHER TESTS
If your child is experiencing any of these
symptoms, or if the curve changes quickly
over time, your child's doctor may order
neurologic tests or a magnetic resonance
imaging (MRI) scan.
 TREATMENT

The goal of treatment is to stop progression of

the curve and prevent deformity. The doctor will
consider several things when determining
treatment for kyphosis, including:

• Age and overall health

• The number of remaining growing years
• The type of kyphosis
• The severity of the curve
 TREATMENT

NONSURGICAL
TREATMENT
• Observation
• Physical therapy
• Nonsteroidal anti-inflammatory
drugs (NSAIDs)
• Bracing
 TREATMENT

SURGICAL TREATMENT

Spinal fusion is the surgical procedure most commonly

used to treat kyphosis.
The goals of spinal fusion are to:

• Reduce the degree of the curve

• Prevent further curve progression
• Maintain the improvement over time
• Alleviate significant back pain, if it is present
 TREATMENT

SURGICAL TREATMENT
• Spinal fusion is essentially a welding
process. The basic idea is to fuse
together the affected vertebrae so
that they heal into a single, solid
bone. Fusing the vertebrae will
reduce the degree of the curve and,
because it eliminates motion between
the affected vertebrae, may also help
alleviate back pain.
 TREATMENT
LONG-TERM OUTCOMES

• If kyphosis is diagnosed early, many patients

can be treated successfully without surgery and
go on to lead active, healthy lives. However,
curve progression could potentially lead to
problems during adulthood.
• Patients with kyphosis need regular to monitor
the condition and check progression of the
curve, whether or not it is treated with surgery.
 LET’S D ISC U SS!

LORDOSIS
• Lordosis is defined as an excessive inward
curve of the spine.
• Lordosis develops if your spine curves too
much and pushes your posture out of its
usual alignment. You might see lordosis that
affects your lumbar spine called swayback.
Remember, lordosis is normal in the cervical
and lumbar spine. In the cervical spine, a 30-
to 40-degree curve is normal. In the lumbar
spine, a 40- to 60-degree curve is typical.
 T Y PE S O F L O R D O S IS

Lordosis of the Lower Back Lordosis of the Neck

 CAUSES

Lordosis in Children Spondylolisthesis

Lordosis in Pregnant Women

when the curve is rigid (fixed), medical evaluation is warranted.

Kyphosis
Obesity Osteoporosis

Discitis
 SY M PTO MS

Top symptoms of lordosis is pain, either in the neck or the lower back
Other symptoms can include:

• Numbness
• Tingling
• Weakness
• Bladder incontinence
 DIAGNOSIS

PHYSICAL EXAMINATION

Diagnosing lordosis is a relatively straightforward

process.
• A doctor will first go about performing a
physical exam in which they look to see if
there is an abnormal inward curvature of the
spine or lack of mobility.
• A physician will likely also order X-rays to be
taken of the patient both of their lateral profile
and their front and back.
 TREATMENT

Luckily, you don’t have to live with that curved

spine forever, as long as you seek treatment for
your lordosis.
• Physical therapy
• Anti-inflammatory medications
• For children and teens, a back brace
• In very severe cases of lordosis, a spinal
surgeon may have to perform surgery
 PREVENTION

“Lordosis tends to arise due to poor posture. If you

are trying to prevent lordosis, keep your shoulders
upwards and pulled back with your chest pushed
out.”

• maintaining a healthy weight

• performing core-strengthening exercises
 PR EV EN TI ON
LORDOSIS
EXERCISE
• Cat-Cow
• Bent-Knee Exercise
 LET’S D ISC U SS!

SCOLIOSIS
• Scoliosis is an abnormal side-to-side
curvature of your spine. Your spine
(backbone) naturally has a slight forward
and backward curve.
• With scoliosis, your spine curves to the left
and right into a C or S shape.
• Most cases of scoliosis are mild, don’t
cause symptoms and don’t need treatment.
Severe cases can cause uneven posture and
pain.
 S C O L IO S I S
T Y PE S O F

Idiopathic scoliosis Congenital scoliosis Neuromuscular scoliosis.

 C O L IO S I S
T Y PE S O F S

IDIOPATHIC
• The term idiopathic means unknown cause.
• Although we do not know for sure what causes the majority of
scoliosis cases (80 to 85%), we do know that it tends to run in
families.
• Scoliosis is not a disease that is caught from someone else, like a cold.
There is nothing you could have done to prevent it.
 C O L IO S I S
T Y PE S O F S

CONGENITAL
• The term congenital means that you are born with the condition.
• Congenital scoliosis starts as the spine forms before birth.
• Part of one vertebra (or more) does not form completely or the
vertebrae do not separate properly.
• Some types of congenital scoliosis can change quickly with growth,
while others remain unchanged.
 C O L IO S I S
T Y PE S O F S

NEUROMUSCULAR SCOLIOSIS
• Any medical condition that affects the nerves and muscles can lead to
scoliosis.
• This is most commonly due to muscle imbalance and/or weakness.
• Common neuromuscular conditions that can lead to scoliosis include
cerebral palsy, muscular dystrophy, and spinal cord injury.
 SY M PTO MS

Scoliosis usually doesn’t cause symptoms, but they may include:

• Back pain.
• Difficulty standing upright.
• Core muscle weakness.
• Leg pain, numbness or weakness.
 SIGNS

• Uneven shoulders. Over time, you may notice:

• Shoulder blades that stick out.
• Head that doesn’t center above your pelvis. • Height loss.
• Uneven waist. • Uneven alignment of your pelvis
• Elevated hips. and hips.
• Constant leaning to one side.
• Uneven leg length.
• Changes in skin appearance or texture
(dimples, hair patches, skin discoloration).
These occur on your back along your spine.
 CAUSES
Vertebrae
Most often, though, healthcare providers malformation during
can’t identify a specific cause (idiopathic embryonic
scoliosis). development.
oh no!!!!

A condition that
affects your nerves
A tumor on A genet or muscles.
your spine ic change
A spine injury.
 R IS K FA C TO R S

• biological family history of scoliosis. But not all cases of scoliosis

are genetic.
• underlying condition or injury that affects spine, muscles and
nerves.
• Scoliosis equally affects all genders and sexes but females are
more likely to need treatment due to the severity of the curve.
 COMPL I C AT I O N S

Without treatment, severe cases of scoliosis can lead to:

• Long-lasting pain.
• Physical deformity.
• Organ damage.
• Nerve damage.
• Arthritis.
• Spinal fluid leakage.
• Difficulty breathing.
 DIAGNOSIS

SCOLIOSIS
SCREENING
During a screening, a provider will ask you to:
• Remove your shirt to see your back.
• Stand up straight.
• Bend forward (like you’re touching your toes).

A screening helps your provider look at your posture, alignment and spinal curvatures.

Scoliosis screenings happen during childhood and adolescence to detect scoliosis early. An early diagnosis
can help your provider offer more treatment options, if necessary.
 DIAGNOSIS

SCOLIOSIS SCREENING
A healthcare provider will diagnose scoliosis after a physical exam.
Before your healthcare provider can suggest a treatment plan,
they’ll ask you questions about the following:
• Your medical history and family medical history.
• The date when you first noticed a change in your spine or the
date of your initial screening.
• Symptoms (if you have any).
• Any bowel, bladder or motor symptoms, which may be signs of
more serious nerve damage or pressure caused by scoliosis.
 DIAGNOSIS

SCOLIOSIS
SCREENING
• If needed, your provider may order imaging
tests. X-rays taken from the front and side will
show a full picture of your spine. Your provider
can then determine if you have scoliosis and if
so, to what degree.
• Other imaging tests may include an MRI
(magnetic resonance imaging) or CT (computed
tomography) scan.
 H O W IS S C O L I O S IS
M E A SU R E D ?

A healthcare provider will measure the curve of your spine in

degrees. They’ll rate the severity based on the degree of the
curve:

• No scoliosis diagnosis: Less than 10 degrees.

• Mild scoliosis: Between 10 to 24 degrees.
• Moderate scoliosis: Between 25 to 39 degrees.
• Severe scoliosis: More than 40 degrees.
 TREATMENT

Treatment for scoliosis isn’t necessary for all cases.

If your provider recommends treatment, they’ll consider several factors:
• The type of scoliosis.
• The degree of the curve.
• Your family history of scoliosis.
• Your age.
• The number of remaining growth years until skeletal maturity.
Treatment focuses on relieving symptoms and not necessarily
straightening the curve. The goal is to decrease symptoms and curve
progression and improve the function of your spine.
 TR EATMENT
Most cases of scoliosis don’t require surgery. Instead,
providers recommend conservative treatment first,
which may include:
• Visiting a healthcare provider regularly
• Taking over-the-counter pain relievers or anti-
inflammatories
• Exercising to strengthen your core muscles and
improve flexibility.
• Wearing a back brace to support your spine.
• Managing any underlying conditions.
Your provider may recommend physical
therapy. This can help you strengthen your
muscles and relieve pain. Your
physical therapist may help you with the
following:
1.Improving your posture.
2.Low-impact exercises, such as swimming.
3.Daily stretching.
4.Physical activity guidance.
 SCOLIOSIS SUR GERY

There are different techniques your surgeon may use to treat scoliosis,
including

• Spinal fusion
• Expandable rod

Advances in surgical techniques and computer-assisted technologies make less

invasive approaches possible and recovery time quicker.
 PR EVENTIO N

Can scoliosis be prevented?

• There’s no known way to prevent scoliosis.
• If you have scoliosis, a healthcare provider
might recommend strengthening your back
and abdominal muscles with stretching and
exercises. These can help prevent the curve
in your spine from getting worse.
 / P R O GN OS IS
OUTLOOK

What can I expect if I have scoliosis?

Though scoliosis is often asymptomatic, symptoms may appear as
your body ages and natural spine degeneration occurs.
• A healthcare provider can help you manage symptoms if they
become bothersome.
• A mental health professional can help you manage how you
feel about your body.

What’s the outlook for scoliosis?

The outlook for scoliosis can vary depending on the type and
severity. Most people can live normally, without any changes to
their routines.
 H SC OLIOSIS
LIVING WIT
What physical activities are safe with scoliosis?
• Most people with scoliosis can participate in physical activities
• Routine movement can reduce the severity of symptoms. If an activity
causes pain, listen to your body and stop.
Can playing sports make scoliosis worse?
Playing sports won’t make scoliosis worse.
• Sports that can help scoliosis include:
⚬ Swimming:
⚬ Gymnastics:
Should certain sports be avoided with scoliosis?
• Most sports, even weightlifting, are generally fine.
• However, if your child had back surgery, they should avoid contact sports.
These include hockey, lacrosse, wrestling and football.
 HEY GUYS

THANK YOU FOR

LISTENING!
 R ES OU R C E S PA G E

https://orthoinfo.aaos.org/
https://my.clevelandclinic.org/health/diseases/15837-scoliosis
https://www.healthcentral.com/condition/back-pain/lordosis