Adolescent Idiopathic Scoliosis Flashcards

1
Q

What is the most common type of scoliosis?

A

Adolescent idiopathic; most are right thoracic curves

If left thoracic must get MRI to r/o syrinx or cyst

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2
Q

What are risk factors for curve progression in adolescent idiopathic scoliosis?

A

1) curve magnitude; >25° before maturity will progress; thoracic curves >50° and lumbar curves >40° after maturity will progress
2) Type; thoracic more likely to progress
3) Growth stage;
Risser 0-1
Open triirradiate cartilage
If curve >30° before peak height velocity, risk for surgery

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3
Q

How are coronal and sagittal balance of the spine determines?

A

Coronal- plumb line from C7 to center of sacrum

Sagittal- center of C7 to posterior-superior corner of S1

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4
Q

In a patient with adolescent idiopathic scoliosis what is an indication to obtain MRI?

A

1) Left thoracic curve
2) asymmetric abdominal reflexes
3) rapid progression
4) foot deformities

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5
Q

When is non-operative treatment appropriate for adolescent idiopathic scoliosis?

A

1) Cobb angle 25° but

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6
Q

At what angle is surgical treatment indicated in adolescent idiopathic scoliosis?

A

Cobb >45°

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7
Q

What are some basics of posterior spinal fusion for adolescent idiopathic scoliosis?

A

1) Goal is to correct sagittal and coronal balance while preserving motion
2) Try to avoid fusing to L4 or L5 to decrease back pain
3) Almost never fused to pelvis

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8
Q

In a patient with thoracic hyperkyphosis in adolescent idiopathic scoliosis, what is a risk of anterior fusion vs posterior fusion?

A

Increased risk of pseudoarthrosis

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9
Q

What is the Risser classification?

A

Risser 0: covers the first 2/3rd of the pubertal growth spurt and correlates with the greatest velocity of skeletal linear growth (Girls 11-13, Boys 13-15); no ilium calcification

Risser I: is given when the ilium calcification measures 25%. As this stage the velocity of linear skeletal growth is on a descending slope.

Risser II: the greater trochanteric apophysis unites with the femur and Ilium calcification measures 50%. There is usually 3 cm of sitting growth remaining and no further growth in the lower extremities.

Risser III: Ilium calcification measures 75%. There is usually 2 cm of sitting growth remaining.

Risser IV: Ilium calcification is almost complete. There is usually 1 cm of sitting growth remaining.

Risser V: marks complete skeletal maturation.

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