Re: Replies: Kyphosis flexibility

Re: Replies: Kyphosis flexibility

Baxter, Steve

6/27/2002

Question?
Can you equate the amount of flexibly measured using a bolster in the supine
position ( which eliminates gravity) to your spinal device worn in an
upright position which is against gravity? Say if your bolster film ( even a
lateral bolster film for scoli) shows a significant degree correction,
should you be able to get that in your device , upright, and againest
gravity?? Just thinking outloud??
Steve Baxter C.O.
Director, Dept. of Orthotics
Shriners Hospital, Houston

        -----Original Message-----
        From: Randall McFarland, CPO [SMTP: <Email Address Redacted> ]
        Sent: Thursday, June 27, 2002 2:32 PM
        To: <Email Address Redacted>
        Subject: [OANDP-L] Replies: Kyphosis flexibility

        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