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The Non-Operative Management of Scoliosis

Teaser: 

Brett Rocos, BSc (Hons), MB ChB, MD, FRCS (Tr & Orth),

Paediatric Spine Fellow, The Hospital for Sick Children, Toronto, ON.

CLINICAL TOOLS

Abstract:Scoliosis is a common condition that every primary care provider will encounter. There are many treatments available in its management, including observation, physical therapy, pain management strategies, casting, bracing and surgery. In this narrative review, the roles of each of the non-operative strategies in managing adult and paediatric scoliosis are explored, and the evidence supporting each is summarised. Scoliosis affects people at every stage of life, and an understanding of the treatments available will aid in counselling patients and making appropriate referrals.
Key Words: Scoliosis, conservative, paediatric, bracing, physiotherapy, alternative therapies, spine cast.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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• Scoliosis is common
• Most patients require observation only
• Patient information is essential
• Casting and bracing have roles in the growing skeleton only
• Physical therapy has limited evidence in both adult and paediatric deformity
• Alternative therapies have no proven use in the management of scoliosis
The majority of patients with scoliosis can be observed
Reliable patient information is critical
There is limited evidence that physiotherapy is effective, and no evidence that alternative therapies are effective in treating scoliosis
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Related Terms: Back Health, Scoliosis, conservative, pediatric, bracing, physiotherapy, alternative therapies, spine cast
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What is Athletic Heart Syndrome?

Teaser: 

Dr. Alykhan Abdulla, BSC, MD, LMCC, CCFPC, DipSportMed CASEM, FCFCP, CTH (ISTM), CCPE, Masters Cert Phys Leader, ICD.D

Assistant Professor University of Ottawa Faculty of Medicine, Academic Clinical Professor University of Ottawa Faculty of Nursing Medical Director The Kingsway Health Centre, The Kingsway Travel Clinic, The Kingsway Cosmetic Clinic, Beechwood Medical Cosmetic Physio Pharmacy, Editor in Chief/Author Journal of Current Clinical Care SPORTS MEDICINE, Vice Chair Section of General and Family Practice Ontario Medical Association, Board Director Eastern Ontario Regional Lab Association, Bruyere Foundation

CLINICAL TOOLS

Abstract: A common term for an enlarged heart that is associated with repeated strenuous exercise is athletic heart syndrome (AHS). This article reviews AHS, other serious conditions that appear similar to AHS, and how to identify a young athlete at risk for sudden cardiac death.
Key Words: athletic heart syndrome, enlarged heart, strenuous exercise, sudden cardiac death.
The changes in heart structure and function seen in athletic heart syndrome would suggest illness if seen in non-athletes.
When abnormalities in heart structure or function are detected in an athlete, it is important to ensure the abnormalities are indeed due solely to exercise conditioning, and not to a cardiac disorder.
Consider a clinical history of drug abuse, the use of anabolic steroids, recent viral infections and very tall athletes with arachnodactily or an arm span greater than their height.
Clinically suspicious athletes need to go for further testing.
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Related Terms: Sports Medicine, athletic heart syndrome, enlarged heart, strenuous exercise, sudden cardiac death
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Navigating the COVID-19 Pandemic as a Healthcare Provider

Teaser: 

Dr. Marina Abdel Malak

is a Family Medicine Resident at the University of Toronto. She graduated and completed her Bachelor of Science in Nursing and went on to study Medicine. She has a passion for medical education, patient empowerment, and increasing awareness about the relationship between mental, emotional, and physical health.

CLINICAL TOOLS

Abstract: The COVID-19 pandemic is an unprecedented situation. Feelings of isolation, uncertainty, fatigue, and a loss of control have created stress among individuals across the world. Healthcare providers are in a position where they must balance their personal, familial, and work obligations during the pandemic. As frontline workers, healthcare providers are particularly vulnerable to the physical, mental, emotional, and social stressors encountered during crises. This can contribute to burn out, physical illnesses, and dissatisfaction. It is therefore essential that healthcare providers are supported in acknowledging and normalizing these feelings, and accessing resources to help them cope. To maintain social distancing and provide around-the-clock services, there are a variety of online resources available to support healthcare providers during this time. By utilizing various coping skills and seeking support, healthcare providers can protect their mental, emotional, physical, and social (MEPS) health during the COVID-19 situation.
Key Words: COVID-19, pandemic, wellness, physical health, resilience.
The COVID-19 pandemic has created a level of uncertainty, fear, and distress across the world. Feelings of isolation, anxiety, and stress are normal during this time.
Healthcare providers are, in particular, are faced with difficult decisions and situations in the COVID-19 crisis. Balancing personal, familial, and work obligations can be extremely challenging.
Mental, emotional, physical, and social health (MEPS) are equally important. As healthcare providers, we cannot take care of others if we do not care for ourselves first.
Various resources are available to help healthcare providers during the COVID-19 pandemic. Developing and utilizing a range of coping tools can promote MEPS health.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Caregiving, COVID-19, pandemic, wellness, physical health, resilience
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Development and Implementation of a National Canadian Spine Surgery Registry

Teaser: 

1Greg McIntosh,2Dr. Michael Craig, 3Dr. Charles Fisher,

1Director of Research Operations, Canadian Spine Outcomes and Research Network.
2Neurosurgery Resident at Vancouver General Hospital, University of British Columbia. 3Professor and Head of the Division of Spine Surgery, Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia.

CLINICAL TOOLS

Abstract:The goal of the Canadian Spine Outcomes and Research Network (CSORN) is to develop a registry for Canadian orthopaedic and neurosurgical spine surgeons to participate in prospective multi-centre trials and retrospective reviews utilizing multivariable analyses. The design allows ongoing research and contains clinical details necessary for epidemiological assessment. Currently, 21 hospital sites, representing 9 provinces, participate CSORN. A total of 81 investigators have enrolled over 11,000 spine patients; 78% thoracolumbar and 22% cervical. Predictive models, effectiveness of surgical procedures, wait time issues and patient-surgeon expectations are some of the specific topics already published with CSORN data.
Key Words: registry, spine surgery, data quality, outcomes.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
Collection, feedback and publication of registry data is now a recognized way of informing clinical practice, driving quality improvement and improving patient outcomes.
The Canadian Spine Outcomes and Research Network (CSORN) is a multicentre national initiative that prospectively enrols consecutive patients with spinal pathology requiring surgical treatment.
The CSORN registry is designed to assess the value of operative techniques on patient outcomes.
Both patients and providers can feel powerless to enact any real change over the healthcare system. Patient participation in a properly designed registry gives them the opportunity to contribute to improving healthcare delivery.
The need for documentation of clinical outcomes is as important in spinal surgery as it is in other medical specialties.
If the value of spine surgery is not well established, then the cheapest options, rather than potentially better ones, are more likely to be endorsed.
Registries require fewer resources and often avoid the constraints of randomized clinical trials; as a result, registry findings usually have strong external validity and generalizability.
Collecting quality of life and patient-reported outcome measures data are essential for treatment evaluation.
Patients (and their physicians) should not fear participation in well-designed registries.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, registry, spine surgery, data quality, outcomes
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