I received a copy of Moe’s "Textbook of scoliosis and other spinal deformities” the other day and have been reading until I basically go blind. My eyes hurt.
One of my questions is “How much mobility does each level have”. In the book it explains about the 6 degrees of freedom, X,Y, and Z which would be, flexion-extension, lateral bending, and axial rotation. Flexion-extension values in degrees are greatest in the cervical and lumbar areas of the spine. Cervical values average about 12degrees for each level. Lumbar flexion-extension values,L3-L4 (15degrees) L4-L5 (17degrees) and L5-Sacrum (20degrees). Lateral bending in these lumbar areas,3-7 degrees, and axial rotation 2-5 degrees.
Not only do we have discs, but we also have something called “facet joints” There are 2 on each level on the backside, and play a major role in determining the range of motion for that joint. Orientation of the facet joints plays a big part in range of motion and pathogenesis of lower back pain.
There are many many parameters involved in scoliosis, its mindboggling. 20 degrees on the lowest joint seems like a large number, its probably a best case scenario, with a normal spine......For those who’s surgeons choose to fuse and leave the lowest levels untouched, this is probably the reason.
Not only are there many different examples of scoliotic spines, some are unbelievable, but one thing I didn’t know was that disc space wedging and vertebral wedging affect cobb measurements. You can have a spine that looks like a 50 degree curve, but it’s really a 90.
Ed
One of my questions is “How much mobility does each level have”. In the book it explains about the 6 degrees of freedom, X,Y, and Z which would be, flexion-extension, lateral bending, and axial rotation. Flexion-extension values in degrees are greatest in the cervical and lumbar areas of the spine. Cervical values average about 12degrees for each level. Lumbar flexion-extension values,L3-L4 (15degrees) L4-L5 (17degrees) and L5-Sacrum (20degrees). Lateral bending in these lumbar areas,3-7 degrees, and axial rotation 2-5 degrees.
Not only do we have discs, but we also have something called “facet joints” There are 2 on each level on the backside, and play a major role in determining the range of motion for that joint. Orientation of the facet joints plays a big part in range of motion and pathogenesis of lower back pain.
There are many many parameters involved in scoliosis, its mindboggling. 20 degrees on the lowest joint seems like a large number, its probably a best case scenario, with a normal spine......For those who’s surgeons choose to fuse and leave the lowest levels untouched, this is probably the reason.
Not only are there many different examples of scoliotic spines, some are unbelievable, but one thing I didn’t know was that disc space wedging and vertebral wedging affect cobb measurements. You can have a spine that looks like a 50 degree curve, but it’s really a 90.
Ed
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