Replies: Kyphosis flexibility

Replies: Kyphosis flexibility

Randall McFarland, CPO

Original post to list:
    Side bending X rays show if scoliotic curves are correctable. Are you
aware of an X ray position/technique that can so evaluate a kyphotic curve?
All I can think of is a supine view with a rolled up towel just inferior to
the apex, but I'm wondering if there is a protocol.
Thanks,
Randy McFarland, CPO

Thanks for the following responses:
We'll typically document flexibility for kyphosis by doing what's known as a
bolster film. It's simply a supine-lateral film, with a firm pad (of
tolerable thickness) placed at the apex of the curve. This sagittal plane
film is then measured using the same vertebral endplate limits that were used
in the standing lateral film (using the Cobb method). The difference between
the two represents the amount of flexibility.
Regards,
Don Katz, CO
Texas Scottish Rite Hospital for Children
Dallas, TX

   IN OUR CLINIC, WE USE A BOLSTER SIMILAR TO A TOWEL RIGHT ON THE APEX OF
THE CURVE. THE IMPORTANT THING TO REMEMBER IS TO ALSO REDUCE LORDOSIS BY
HAVING THE PATIENT FLEX THE HIPS AND KNEES WITH FEET ON TABLE IN A SUPINE
POSITION. STANDING FILMS UNBRACED
SIMPLY PRODUCE MORE LORDOSIS AS THE PATIENT TRIES TO LEAN BACK.
KEITH M. SMITH, CO

Many years ago (1975) at Hospital for Special Surgery in NYC, the protocol
was Lateral Extension. Just stretch hands together overhead and look-up to
the ceiling. Use high MA/ Short time. No long breathing technique exposure
here. The old folk get dizzy looking up. Take too long and you are calling
for the crash cart.
Charles Barocas