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Adolescent Idiopathic Scoliosis Class > AIS Part 1: Definition and Diagnosis > Flashcards

AIS Part 1: Definition and Diagnosis Flashcards

1
Q

What is the age of onset that defines AIS?

A
  • Onset over age 10 prior to skeletal maturity
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2
Q

What is the age of onset for Juvenile Scoliosis?

A

4-9 years old at onset

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3
Q

What is the age of onset for Infantile Scoliosis?

A

0-3 years old at onset

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4
Q

List 5 examples of other (non-AIS) structural categories of scoliosis (from other causes)

A
  1. Congenital Scoliosis (vertebral birth defect)
  2. Syndromic and Neuromuscular scoliosis
  3. Tumors, Chiari Malformations, other diseases
  4. Post surgical/post traumatic scoliosis
  5. Adult Onset Degenerative Scoliosis
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5
Q

Describe the typical shape of deformity for Idiopathic, Neurological, and Congenital scoliosis

A
  1. Idiopathic: 1-2 more balanced curves with some vertebral wedging.
  2. Neurological: one sweeping curve over entire spine. No vertebral wedging.
  3. Congenital: fairly straight spine with one area of sharp curves with severe vertebral wedging
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6
Q
  1. Describe some typical characteristics of Neurological scoliosis
A
  1. behaves differently from AIS
  2. more neuromuscular involvement correlates with likelihood of scoliosis and how much deformity is present
  3. In one year, progression of curve can be as much as 40 degrees.
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7
Q

What are 6 neurological conditions that are related to neurological scoliosis (and prevalence if you want)

A
  1. CP (25%)
  2. Myelodysplasia (60%)
  3. Spinal amyotrophy (67%)
  4. Friedrich’s Ataxia (80%)
  5. Duchenne myopathy (90%)
  6. Medullary lesion - over 10 years old (100%)
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8
Q

Describe Adult Degenerative scoliosis

A
  1. gradual degeneration of spine leads to misalignment
  2. Structural loss of integrity in soft tissues such as the disc, facet, ligament
  3. Must be identified as adult onset (not AIS in an adult)
  4. Usually lumbar spine
  5. Pain may be present, or not
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9
Q

Traditional general definition of AIS

and better definition

A

Traditional = Lonstein: “Lateral curve of the spine in an otherwise healthy child, for which a currently recognizable cause has not been found”

Better to acknowledge it is a complex 3D deformity involving morphological as well as geometric changes, changes in relation to many factors during rapid growth or in later life. Not well understood and occurs in healthy children.

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10
Q

What are two components of AIS

A

Structural (non flexible): such as vertebral deformity and possible other deformities of nearby bones and soft tissues.
Postural (flexible)

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11
Q

Clinical criteria for AIS

A

Adams Forward Bend test over 5-7 degrees with scoliometer.

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12
Q

Radiological criteria for AIS

A
  1. Cobb Angle over 10 degrees
  2. Axial rotation of vertebra
  3. Vertebral body deformity
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13
Q

Where does AIS initiate?

A

deformity of a vertebral body. Then the rest of the spine adapts.

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14
Q

In a study by Ko Ishida et al SOSORT IRSSD Meeting, 2016, what percentage of AIS pts had osteopenia or osteoporosis?

A

65%

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15
Q

How may planes does the vertebral deformity occur in?

A

3, transferse, coronal, sagittal (usually relative anterior spinal overgrowth)

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16
Q

when are the two periods of maximum growth acceleration?

A

Age 6-8

puberty (most significant)

17
Q

Risk of progression can be predicted based on what?

A
  1. Cobb angle
  2. Current pt age
  3. Risser score
18
Q

Define mild, moderate, and severe scoliosis with cobb angle

A

Mild: cobb 10-25 degrees
Moderate: Cobb 25-40 degrees
Severe: Cobb 40+

19
Q

What is the numeric range of Risser scale?

A

0-5

20
Q

What equation can be used to predict progression?

A

Lonstein-Carlson Equation

21
Q

Other variables to consider when looking at risk of progression

A
  1. Age of dx
  2. Menstruation onset (but not as helpful as first thought)
  3. family hx
  4. add’l morph characteristics such as severity of rotation, rigidity
  5. comorbidities such as hypermobility, hypotonicity
22
Q

What scale can be used to assess hypermobility?

A

Beighton scale

23
Q

What are 2005 SOSORT tx guidelines for percent risk of progression (RFP) using Lonstein-Carlson equation

A 
<20% observe and edu
20-40% PT
40-60% Intense PT and early bracing
60-80% Intense PT and full or part time bracing
80%+ Intense PT and full time bracing

Adolescent Idiopathic Scoliosis Class (2 decks)

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