Tuesday, 15 April 2014

Exercises That Help Scoliosis

Scoliosis is a condition where the spine is either curved too far forward or backward. It can occur at any age, but it usually develops in children after age 10. Scoliosis causes the vertebrae to twist and become deformed. As a result, a looseness and weakness can occur in the ligaments and muscles. However, there are exercises that can help stabilize the spine and alleviate pain.


     Yoga Exercises
  • Yoga can work wonders for people with scoliosis.

    Place your elbows on a table. Allow your lower back to arch. Hold this for up to a minute. This is a good warm-up exercise.

    The seated twist can be done in a chair or on the floor. Simply twist your body to each side and stretch the muscles. Do 10 repetitions.

    The standing cat stretch: While standing, place your hands (fingers pointed inward) above your knees, bend forward and hunch your back. This exercise will stretch all major muscles and ligaments in the hips and lower back.

    The crocodile: Lie on your stomach and cup your chin between both hands. Prop yourself up on your elbows and hold this position. Relax.

    Standing-forward fold: With your legs more than shoulder-width apart, squat down with your elbows out and hands folded together. Hold this position for a minute or so, then relax. You will gradually be able to do this exercise longer.

Exercises for Lower Back and Abdomen

  • Stretching and strength-building exercises can reduce pain and correct some of the abnormal curve of the spine. Hold each movement about five seconds. Try to do 10 repetitions for each exercise at least three times per week. Do not do an exercise if it causes too much discomfort.
    Lower-Back Exercises:

    Lie on a hard surface, and let the spine align itself naturally for a couple of minutes. This will help any type of spine curvature.

    While lying down with your knees up, press your lower back against the floor. Relax, then repeat for the recommended number of repetitions. This exercise can enhance stability in the spine and build the muscles around it.

    Extend one leg. Pull the knee of the other leg toward your upper body. Repeat with the other leg. This exercise will stretch each side of the lower back. Next, pull both knees up and hold them against the chest. Let both feet fall to the floor, then repeat.

    Keeping your knees up while on your back, push up with your feet and lift your buttocks off the floor. This exercise strengthens the muscles between the lower and middle back. Adjacent muscle groups need to be worked to help stabilize the vertebrae in the curved area of your spine..

    Kneel down on a mat and put your hands on the floor. Slowly move the left leg up and extend it backward. Bring the leg back down, then repeat with the other leg. This back-extension movement hits a number of supporting muscle groups.

                                 Abdominal Exercises:

    Leg lifts can be done while lying on the floor. With your legs extended, slowly raise them up about six inches and hold. Lower the feet, then repeat the motion. It is very important for those with scoliosis to work their abdominal muscles.

    Crunches are another exercise for building strength in the abdomen. Place your hands behind your head. With both knees propped up, lift your body straight up toward your legs, then return to the floor. You can try twisting to each side as you come up as well. Do not twist if it causes you more pain.

                               Upper-Back Exercises

  • Upper-back exercises should only be performed twice per week. Do up to three sets,10 repetitions each.

    One-arm rows help build your upper-back muscles. Kneel on a bench with one leg while extending the other one back. Grab a light dumbbell from the floor and slowly lift it up to the outer chest area. Inhale while you lower the weight, and exhale while lifting it.

    Seated rows can be performed at a gym or with homemade equipment. Pull the weight toward you, then take it back to the starting position.

    Place a chin-up bar in the doorway about waist high. Lean at an incline under the bar. Take a deep breath, then exhale as you pull yourself up. Inhale as you lower yourself back down. 

    Source : Ehow.com

Saturday, 12 April 2014

Kyphosis Exercises

Kyphosis Exercises 3aa/a2-kyphosis-sit on a back

3aa/a2-kyphosis-sit on a back

Kyphosis Exercises Kyphosis: a humpback

Kyphosis: a humpback

Kyphosis Exercises Exercises for good posture

Exercises for good posture

Kyphosis Exercises A kyphotic spinal deformity

A kyphotic spinal deformity

Kyphosis Exercises Perform exercises with the

Perform exercises

Kyphosis Exercises The "two stool" exercise for

The "two stool" exercise

Kyphosis Exercises Definition of kyphosis

Definition of kyphosis

Kyphosis Exercises Kyphosis exercise 1

Kyphosis exercise 1

Kyphosis Exercises On kyphosis � the hunched

On kyphosis � the hunched

Kyphosis Exercises The "door frame" exercise for

The "door frame" exercise

Kyphosis Exercises Exercises for good posture

Exercises for good posture

Kyphosis Exercises Kyphosis (extreme curve of the

Kyphosis Exercises Kyphosis has several causes.
Kyphosis has several causes.

Kyphosis Exercises Pilates-warm_up-exercises- ...

Pilates-warm_up-exercises- ...

Kyphosis Exercises Kyphosis results in a

Kyphosis results

Floating spine after pedicle subtraction osteotomy for post-traumatic kyphosis



Pedicle subtraction osteotomy (PSO) was developed to achieve significant correction of a deformity. It was initially used to correct sagittal plane deformities associated with ankylosing spondylitis, but recently it has also been performed in patients with post-traumatic kyphosis. Our aim was to report a case of a floating spine after PSO for post-traumatic kyphosis.


A 50-year-old man was injured after a fall. He had a compression fracture at T12 and an open fracture of the right lower limb. Although he presented with focal back pain, his open fracture was treated first by surgical intervention. The T12 compression fracture was treated conservatively. One year later, he had lower limb numbness and muscle weakness. His imaging demonstrated focal kyphosis on T12 and spinal cord compression. The diagnosis was post-traumatic kyphosis, which was treated with PSO. We performed osteotomy at T12, discectomy and bone graft at T11–T12, and posterior fusion from T10 to L2.


One year after PSO, we removed the instruments because he complained of pain around them and found complete bony union between T11 and T12. He immediately experienced worse pain and could not walk or stand for more than 10 min. Imaging showed a floating spine between T12 and L1. He underwent anterior fusion at T12–L1, after which his severe back pain disappeared.


This case points out a pitfall of PSO. Although it is a powerful tool for correcting an imbalanced spine, we should recognize its pitfalls and try to avoid them.

Source : European Spine Journal , April 2014 Via Springer

Wednesday, 9 April 2014

Walking taller, straighter

For James Dal Santo, a 5-mile run on a weekend morning used to be no big deal, a relatively easy exercise that helped him stay in shape for cross country and track.

James Dal Santo organizes his books for Nick DeLazzari, one of the students who has volunteered to help carry things for James while he recovers from surgery.

James Dal Santo organizes his books for Nick DeLazzari, one of the students who has volunteered to help carry things for James while he recovers from surgery.James Dal Santo organizes his books for Nick DeLazzari, one of the students who has volunteered to help carry things for James while he recovers from surgery.

James Dal Santo packs up his bookbag at the end of the day while his friend Nick DeLazzari waits to carry his things.

James Dal Santo packs up his bookbag at the end of the day while his friend Nick DeLazzari waits to carry his things.

James Dal Santo walks through the halls of Wyoming Valley West High School with Nick DeLazzari, who is carrying James' books for him.

James Dal Santo walks through the halls of Wyoming Valley West High School with Nick DeLazzari, who is carrying James' books for him.

Nancy Rowlands, physician assistant, and Dr. Meagan Fernandez examine James Dal Santo during a recent check-up.

Nancy Rowlands, physician assistant, and Dr. Meagan Fernandez examine James Dal Santo during a recent check-up.

Nancy Rowlands, physician assistant, and Dr. Meagan Fernandez examine James Dal Santo during a recent check-up.

Nancy Rowlands, physician assistant, and Dr. Meagan Fernandez examine James Dal Santo during a recent check-up.

James Dal Santo of Kingston goes for a walk with his mom, Beth, in January, a few weeks after his surgery.

James Dal Santo of Kingston goes for a walk with his mom, Beth, in January, a few weeks after his surgery.

Today, as the 16-year-old scholar/athlete from Kingston continues to recover from surgery that corrected a serious case of scoliosis, any little jog is a triumph that gets him closer to his return to competition.

“I’ll just do a block here and there,” said Dal Santo, whose once-twisted spine is straightened and held in place by rods made from titanium and cobalt chrome.

Dr. Meagan Fernandez, the orthopedic surgeon who corrected the curvature during a seven-hour operation on Dec. 16 at Geisinger Medical Center in Danville, fully expects Dal Santo to return to the sports he loves — and says at least part of that will be thanks to improved technology.


Another helpful breakthrough in surgery to correct scoliosis is robotic technology. The Mazor Robotics Renaissance System Dr. Meagan Fernandez used at Geisinger Medical Center increased the safety and accuracy as tiny screws are put into the small bones in a patient’s spine, she said. It also decreased the recovery time.


“The instrumentation we use has changed dramatically, the screws and rods that he has in his back,” the surgeon said in a telephone interview. “We used to use wire exclusively, and kids were never allowed — once you had surgery for scoliosis — never allowed to ever do anything again.”

“I just saw him at the 3-month (post-surgery) mark, and he’s doing OK. He’s doing fantastic,” Fernandez said. “He’ll be released to go full-steam at the six-month mark.”

For now, Dal Santo has plenty of activities to keep him busy, including a project regarding the area of triangles that won him a first-place award at the Pennsylvania Junior Academy of Science, held recently at Wilkes University.

The honor student has been back in class at Wyoming Valley West High School in Plymouth for weeks, and his mom, Beth Dal Santo, says he didn’t miss very much school time because of the many snow days this winter.

“The school is great. They are so accommodating,” Beth Dal Santo said, explaining her son is allowed to leave classes early so he can get to the next class on time. Some of his friends, including Nick DeLazzari and Billy Stone, have similar schedules and carry books for him.

“I’m glad to help my good friend,” DeLazzari, 15, said on a recent Wednesday as he carried Dal Santo’s books from Ms. Wills’ chemistry lab to his locker. “We’ve been friends since Cub Scouts.”

Dal Santo’s spinal curvature, which Fernandez described as “almost 40 degrees over 60” was a case of adolescent idiopathic scoliosis, which means the cause is not known. “He has no other medical condition like cerebral palsy or neuromuscular disorders,” the doctor said.

Many people believe scoliosis strikes more girls than boys, Fernandez said, but that is not true. “It affects about as many males as females, but females are eight times more likely to have a case that progresses to moderate or severe.”

Signs that a person might have scoliosis include one shoulder higher than the other, one hip higher than the other, or a “crease” at the waist, which would make the individual’s waist appear uneven.

“If kids are going to progress with scoliosis,” Fernandez said, “it often happens during periods of peak growth velocity at puberty.”

In Dal Santo’s case, he had grown 6 inches in one year about the time he started to feel a certain unevenness.

In the aftermath of his surgery, Dal Santo has experienced pain. On a recent day of very cold weather, after he had tripped over some furniture, he did stay home from school. “My back was killing me,” he explained. But the next day he was back in class and said he was feeling OK.

“I wish all our students were so motivated,” principal Erin Keating said. 

By : Mary Therese Biebel
Email :   mbiebel@civitasmedia.com

Source : Times Leader , 8th April 2014 

Saturday, 5 April 2014

Two spine surgeons are 3 times safer than 1

A new team approach has improved safety—reducing rates of major complications by two thirds—for complex spinal reconstructive surgery for spinal deformity in adult Group Health patients at Virginia Mason Hospital & Seattle Medical Center. An article in the March issue of Spine Deformity gives a detailed description of the standardized protocol before, during, and after the surgery, stressing the new approach's three main features:
  • Two spine surgeons in the operating room.
  • A live preoperative screening conference.
  • Monitoring bleeding during the operation
The research team reviewed 164 consecutive patients: 40 before and 124 after the new three-pronged approach was implemented. After implementation, patients were three times less likely to develop major complications. Improvements included significant reductions in rates of wound infection, deep vein thrombosis, pulmonary embolism, and urinary tract infections. Patients were also significantly less likely to have to return to the operating room within 90 days after the surgery.

This image shows Rajiv Sethi, M.D., an orthopedic spinal surgeon in neurosurgery at Group Health, director of spinal deformity and complex reconstruction at Virginia Mason, and clinical assistant professor of health services at the University of Washington School of Public Health (left) and Jean-Christophe Leveque, M.D., a neurosurgeon at Group Health and Virginia Mason (right).

"We can shorten the operation when we have two surgeons in the operating room as equal partners: a neurosurgeon and an orthopedic surgeon with specialized spine training," said lead author Rajiv K. Sethi, MD. He is an orthopedic spinal surgeon in the neurosurgery department at Group Health Physicians, the director of spinal deformity and complex reconstruction at Virginia Mason, and a clinical assistant professor of health services at the University of Washington (UW) School of Public Health.

"Reconstructive surgery for adults with spine deformities like scoliosis and kyphosis is being done increasingly often," Dr. Sethi said. "But this kind of surgery tends to be long and difficult, and it is among the most dangerous and complication-ridden of all operations. And often the outcomes and complications are unacceptable, including some patients losing more blood than they started with." That's why the new approach uses a standardized protocol to monitor and manage any bleeding during the operation.

The new approach also involves a feature that has never been described before: a live conference with clinicians from various disciplines. They are the operative surgeons, an internist, a physical medicine and rehabilitation physician, the nurses who coordinate a class for complex spine patients, and at least two members of the anesthesiology team dedicated to complex spine surgery. Together, they identify and treat health and medication issues that, undetected, might otherwise have derailed an operation at the last minute. Planning well in advance, they discuss—and decide—whether proposed surgery is appropriate for each patient.

"Our findings could help medical teams at Group Health and around the country reduce complications—and likely cut costs too—while improving performance and patient outcomes," Dr. Sethi said. "But all clinicians at Group Health and Virginia Mason are paid on salary. By contrast, at medical centers where doctors are paid on a fee-for-service basis, with more pay for doing more procedures, it might be harder to institute this kind of systems approach, because it entails up-front costs and commitment from leadership." 

Source : Science Codex , 26th March 2014

Instrumented arthrodesis for Duchenne muscular dystrophy scoliosis improves activity levels

Functional outcomes for patients with Duchenne muscular dystrophy scoliosis appeared to have improved after surgery compared to patients who were treated conservatively without surgery. 

“Patients with Duchenne muscular dystrophy scoliosis who have surgery have improvement in activities of daily living compared with patients treated conservatively and the improvement in the activities of daily living is mainly related to sitting ability. The muscle power and forced vital capacity were decreased in both groups at the final evaluation, but the ratio of forced vital capacity deterioration was significantly slowed in the surgical group,” Kyung Soo Suk, MD, and colleagues wrote in their study.

Researchers studied 77 patients with Duchenne muscular dystrophy scoliosis who were about 15 years old. They were referred to the department of orthopaedic surgery at Kyung-Hee University College of Medicine, in Seoul, Republic of Korea, from 2003 to 2010. The patients could not walk and were wheelchair bound at the time, according to the study.

Forty-five patients underwent instrumented spine arthrodesis surgery with CD Horizon instrumentation (Medtronic: Memphis, Tenn.) and 32 patients received conservative treatment with no surgery, Suk and colleagues wrote. Six patients, 3 patient in each group, did not participate in the 2-year follow-up and were not included in final results of the study. Two patients in the surgical group and three patients in the non-surgical group died before the 2-year follow-up.

Suk and colleagues reported the mean Cobb angle was significantly smaller in the surgical group than the non-surgical group at the final follow-up. The surgical group also reported improvement in their activities of daily living and pulmonary function, based on the results.

“Post-operatively, the results on the Muscular Dystrophy Spine Questionnaire (MDSQ) showed that the activities of daily living, especially sitting ability, were markedly improved after spinal surgery in patients with Duchenne muscular dystrophy scoliosis; however, the MDSQ was not available at the time of the initial consultation,” Suk and colleagues wrote. 

Source : Healio , 2nd April 2014

Scoliosis may strike gradually

Scoliosis, a curving of the spine, may increase so gradually that parents may not even notice. 

Scoliosis, a curving of the spine, may increase so gradually that parents may not even notice.

Pete Stasikelis, an orthopedic surgeon at Shriners Hospitals for Children — Greenville, said it is not uncommon for him to see curves of 65 – 75 degrees that have gone unnoticed. And no, that doesn't mean parents are neglectful or out of touch.

"Most people aren't looking at their kids' backs," Stasikelis said. "It's common for families not to notice until it's bad."

Stasikelis said the term scoliosis is quite broad and may have many causes. Some strike very early in life. Adolescent idiopathic scoliosis may not appear until children begin rapid growth. According to Stasikelis, it would rarely be found before about age 10. When the curvature is noticed, Stasikelis said patients need an evaluation to make sure there aren't other conditions causing the scoliosis.

"Growth is like the gasoline that fuels the fire of progression," Stasikelis said. "As soon as you notice it, I would like to treat it."

A child's pediatrician can screen for scoliosis or parents can bring their children to one of Shriners Hospital's free screening events.

If scoliosis is diagnosed and other problems are ruled out, a treatment plan, if one is needed, should be made.

"Scoliosis is definitely in the bone," Stasikelis said. "A lot of people have a misconception that it's the discs or they can stretch a certain way (to correct it)."

Treatment may not be needed at all. For some patients, bracing may be indicated. For others, surgery may be required.

"The vast majority won't need surgery," Stasikelis said. "Bracing has been shown to be effective in preventing curve progression, if you can get the kids to buy into it. (Curvatures of) less than 45 – 50 degrees don't need surgery unless they are very young with lots of growth left. If they are religious about wearing the brace, maybe 25 percent would need surgery. We would like to push the surgery back as late as possible."

For those patients who does require surgery to correct the curve, Stasikelis said the results are generally very good.

"Something like 97 percent of people are happy with their surgery," he said. "It's a highly successful surgery."
Stasikelis said even if patients do need surgery, life can still be active and full.

"Whether they need surgery or not, they can be active – play sports, work on a farm," he said. "It's not going to severely impact your life."

Free screening

Are you worried your child may be dealing with an orthopedic condition, including cerebral palsy, spina bifida, scoliosis, club feet, genetic disorders or sports injuries?

A free orthopedic screening will be held at Shriners Hospital — Greenville 9 a.m. – noon May 3. No appointment is required. For more information, contact Ashley Taylor at 864-255-7863 or ajtaylor@shrinenet.org.   

Source : Gree Ville Online , 3rd April 2014

Proud mum’s dream toystore treat for Patrick

Patrick Haren34

BRAVE 11-YEAR-OLD Boho schoolboy Patrick Haren has a rare spinal condition and mum, Wendy, is hoping to raise funds take to him to a party at a world famous London toy store next month.

Patrick, a pupil at Killyhommon in Boho, lives just outside Derrygonnelly with his mum, three brothers and sister.

He was diagnosed with severe ‘scoliosis’ as well as ‘kyphosis’ when he was young leaving him with a condition in which his spine is at an angle of almost 100 rather than 180 degrees.

As Wendy explained, “Patrick was born in 2002, he spent the first year of his life in hospital and very quickly from about the age of three and a half developed scoliosis, which is a curvature of the spine.

“It is very severe, it’s almost 100 degrees – and he has got a very prominent kyphosis with it, which leaves him with a hump on his back.”

Patrick had surgery six years ago, which was unsuccessful and left him paralysed for four months. Any further surgery would have to be carried out in America, at great expense.

“He is also very small for his age, but he has got the mind of an 11-year-old and is a very bright boy,” Wendy went on.

“There is nobody else quite like him in Nothern Ireland, so I’ve met people from different groups – especially in England, who have it but not quite as severe as Patrick.”

Wendy said how Patrick had to copoe with pain on a daily basis.

“He would be very sore – I don’t know how he copes with it himself. He would rarely get a full week at school because he gets very tired. He doesn’t participate in sports in school as he can’t physically do it.

“But he loves the Xbox, he’s very close with his brothers – they’re all very good to him and love him dearly.

“He loves art and he loves computer – he’s not very interested in written work – but he has a classroom assistant who is very good to him.”

The party that Patrick has been invited to takes place in Hamley’s toy shop in London on Sunday May 18. He is among 60 children invited, all with similar conditions.

Boys will dress as pirates and girls as princesses for the party. But, in order to get Patrick to London, Wendy need to raise money for travel and accommodation.

“I would love him to go. If he was to go we’d travel the evening before so we could stay overnight in a B and B so that he could recover from the travel, so that he will be refreshed for the party on Sunday morning.

“He doesn’t get to spend any time with children like himself at home, so it would be good to let him know that he’s not alone – and that there are other children with the condition like him.”

To donate to Patrick’s cause, you can visit: http://www.gofundme.com/613wa8.