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Chance Fracture
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Non-operative management should be reserved for neurologically intact patients with stable fracture patterns, stable posterior elements and less than 15 degrees kyphosis. This should be with a thoracic lumbar sacral orthosis (TLSO) brace in extension for 3 months. These patients should be serially assessed radiologically to exclude progressive kyphosis and/or non-union.
Bones and fractures
Published in Henry J. Woodford, Essential Geriatrics, 2022
Vertebral fractures most commonly occur in the low thoracic to upper lumbar region. They are defined as loss of 20% of vertebral body height, or a 4 mm reduction, which is best seen on plain X-ray images. They may be asymptomatic (detected only on imaging, also termed ‘morphometric') or present as progressive spinal curvature (kyphosis), height loss (more than 2 cm in a three-year period is suggestive), chronic back pain, or acute back pain following minor trauma. MRI scanning can distinguish between acute and old fractures. Spinal cord compression can occasionally occur. Two-thirds of fractures are believed to be asymptomatic, resulting in under-diagnosis and the true prevalence being unknown. Around half of women in their 80s have been found to have some vertebral deformity.54 Underlying osteoporosis should be suspected when detecting a kyphosis clinically.
Eating, drinking and swallowing in the context of older age
Published in Rebecca Allwood, Working with Communication and Swallowing Difficulties in Older Adults, 2022
Age-related postural changes may have an influence on swallowing ability. Kyphosis of the spine (curvature of the thoracic section of the spine) occurs with age to varying degrees (Katzman et al., 2010). For those older people with a more significant kyphosis, the ability to maintain a good upright posture to facilitate the timely and safe passage of food or drink into the stomach might be restricted.
Validity and reliability of the block method for measuring thoracic hyperkyphosis
Published in Physiotherapy Theory and Practice, 2022
Pakwipa Chokphukiao, Arpassanan Wiyanad, Patcharawan Suwannarat, Sugalya Amatachaya, Lugkana Mato, Pattra Wattanapan, Chitanongk Gaogasigam, Thiwabhorn Thaweewannakij
Kyphosis can be measured using both radiographic and non-radiographic techniques (de Oliveira et al., 2012; Lewis and Valentine, 2010). The gold standard for quantifying the kyphosis angle is Cobb’s method, which directly determines the angle from a standing lateral radiograph (Barrett, McCreesh, and Lewis, 2014; Katzman, Wanek, Shepherd, and Sellmeyer, 2010). Although Cobb’s method has excellent reliability, it requires a spinal radiograph and exposure to potentially unnecessary radiation. Furthermore, it is difficult to identify bony landmarks on a radiograph, and an expert is needed to assess the kyphosis angle (Azadinia et al., 2014; Kado et al., 2004; Perriman et al., 2010; Tran et al., 2016). Thus, alternative non-radiographic methods, such as the Debrunner kyphometer, inclinometer, flexible ruler, occiput wall distance, and block method, have been developed (Azadinia et al., 2014; Barrett, McCreesh, and Lewis, 2013; Hinman, 2004; Kado, 2009; Katzman et al., 2011; Perriman et al., 2010; Wongsa et al., 2012). All these non-radiographic methods, except for the block method, require an expert with a basic knowledge of human anatomy to identify spinal bony landmarks (Tran et al., 2016).
Three column osteotomy for adult spine deformity: comparison of outcomes and complications between kyphosis and kyphoscoliosis
Published in British Journal of Neurosurgery, 2018
Jun Qiao, Lingyan Xiao, Xu Sun, Zhen Liu, Zezhang Zhu, Bangping Qian, Yong Qiu
Kyphosis refers to abnormally excessive convex kyphotic curvature of the spine as it occurs in the cervical, thoracic and sacral regions.1 Kyphosis could be classified as postural kyphosis, Scheuermann's kyphosis, congenital kyphosis, nutritional kyphosis, Gibbus deformity and post-traumatic kyphosis.2 Kyphoscoliosis describes an abnormal curvature of the spine in both a coronal and sagittal plane.3 It is a combination of kyphosis and scoliosis. Kyphoscoliosis may manifest in an individual at different stages of life and for various etiologies. In addition to cosmetic problems, many patients have significant back pain and functional disability due to the spinal imbalance associated with the kyphosis or kyphoscoliosis.4 For severe rigid kyphosis and kyphoscoliosis, three-column osteotomies, including pedicle subtraction osteotomy and vertebral column resection could provide adequate correction of the deformity.5–7 To date, no study has examined the difference in surgical outcomes and complications between these two types of spine deformities. The aim of this study was to compare the surgical outcomes and complications between kyphosis and kyphoscoliosis when using three-column osteotomies.
Relationship between kyphosis and cough strength and respiratory function of community-dwelling elderly
Published in Physiotherapy Theory and Practice, 2022
Hiromichi Takeda, Yoshihiro Yamashina, Kazuyuki Tabira
The kyphosis index was used to assess kyphosis; its reproducibility and reliability have been previously established (Lundon, Li, and Bibershtein, 1998; Milne and Lauder, 1974). The kyphosis index was obtained by molding a flexible curve ruler along a participant’s spine from the level of C7 to L4. We traced the molded ruler on paper and drew a straight line from C7 to L4. The kyphosis index was calculated as the height (H) divided by length (L) (Figure 1). The higher the kyphosis index, the more severe kyphosis is. Since this was highly reliable between and within examiners, even with participants in the sitting position (Teragaki et al., 2004), the sitting position was measured in consideration of participants’ safety.