Orthotic Treatment Management of Kyphosis

Definition
Increased anterior concavity of the normal thoracic curve. Or reduction of its normal lordotic curve in the lumbar spine
Causes
• Congenital (structural)
• Postural
• Spine Muscular abnormality
• metabolic problems, nutritional deficiencies
• secondary to osteogenesis imperfecta, spina bifida, Scheuermann’s disease
Signs & Symptoms
• Difference in shoulder height
• The head bends forward compared to the rest of the body
• Difference in shoulder blade height or position
• When bending forward, the height of the upper back appears higher than normal
• Tight hamstrings (back thigh) muscles
Orthotic Treatment
Treatment of kyphosis is depending on the age of patient, cause of lordosis, apical vertebrae and the magnitude of the kyphosis Cobb’s angle. Types of Orthosis for kyphosis treatment:

• Milwaukee brace for apex above T9
• TLSO for apex below T9 and thoracic lumbar curves,
Orthosis is used for vertebral wedging greater than 5ºand curves between 45º-65º
The Biomechanical principle of application of forces are used in the Orthosis, those are 3 Point pressures (in sagital plane)
• One corrective force toward the apical vertebra
• Two counter forces located proximal and distal to the corrective force, to stabilize the proximal and distal segment of the curve, so that the correction can be achieved.
Complications
• Compression fractures due to osteoporosis
• Deformity become severe
• Affects in function and structural of internal organs
• Neurological deficit
Orthotic Treatment post complication
Orthotic treatment for untreated kyphosis is depending on the complication. The treatment should be in preference of correction of kyphosis, and then followed the treatment of complication.

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