Bone Disorders Of The Spine

Question 1

Grading scale of spondylolisthesis

Answer 1

Grade 1 = 0-25%
Grade 2 = 25-50%
Grade 3 = 50-75%
Grade 4 = 75-100%

Question 2

Scheuermann’s disease usually has a kyphotic curve greater than _______ degrees

Answer 2

45

Question 3

Grading for vertebral body compression fracture

Answer 3

Grade 0 = normal
Grade 1 = 20-25% height decrease
Grade 2 = 25-40% height decrease
Grade 3 = >40% height decrease

Question 4

Treatment of scoliosis based on Cobb angles

Answer 4

<20º = observe
20-40º = brace
>40º and skeletally immature = surgery
>50 º and skeletally mature = surgery

Question 5

When do you consider surgery for spondylolisthesis?

Answer 5

Symptomatic Grade 3, and Grades 4 and 5

Question 6

What grade of spondylolisthesis do you restrict patient from contact sports

Answer 6

> Grade 2

Question 7

Most common type/class of spondylolisthesis

Answer 7

Class II (Isthmic) which is due to par interarticularis fracture

Question 8

An adolescent disorder of the vertebral endplates and apophysis resulting in increased thoracic kyphosis

Answer 8

Scheuermann’s disease

Question 9

If there is pain walking downhilll, is that neurogenic or vascular claudication?

Answer 9

Neurogenic

Question 10

If there is pain in the calf with riding a bike, is that vascular or neurogenic claudication?

Answer 10

Vascular

Question 11

How many hours a day do you wear a brace for scoliosis, and how long do you wear it?

Answer 11

23 hours/day until skeletally mature and curves are stable

Question 12

What is the Pavlov ratio?

Answer 12

AP diameter of canal : AP diameter of vertebral body
Nml = 1.0
Stenosis = <0.82

Question 13

3 types of scoliosis

Answer 13

Idiopathic, congenital, neuromuscular

Question 14

After a stable vertebral body burst fracture, how long do you brace for?

Answer 14

4-6 months

Question 15

What type of brace do you use for a lower thoracic, thoracolumbar or lumbar curves?

Answer 15

Low profile TLSO

Question 16

What do you see on imaging of the spine in scheuermann’s disease

Answer 16

Schmorl’s nodes

Question 17

What is the diameter of spinal canal in central spinal stenosis?

Answer 17

< 10 - 12 mm

Question 18

What type of brace do you use for a high thoracic curve?

Answer 18

Milwaukee brace (CTLSO)

Question 19

When do you consider bracing vs surgery for scheuermann’s disease?

Answer 19

Bracing if kyphosis is <75º and surgery if >75º.

Question 20

What is mechanism of injury that causes spondylolysis

Answer 20

Repetitive hyperextension forces

Question 21

How much of vertebral translation is spondylolisthesis considered instability?

Answer 21

In C-spine = >3.5mm

In T- or L-spine = >5mm

Question 22

What kind of exercises do you recommend for scheuermann’s disease

Answer 22

Thoracic extension and abdominal strengthening exercises

Question 23

What are schmorl’s nodes

Answer 23

Herniation of disc material through the endplates

Question 24

If there is a double major scoliotic curve, what is the usual pattern?

Answer 24

Right thoracic and left lumbar curve

Question 25

In a thoracic curve, at what level is the apex usually at?

Answer 25

T7 or 8

Question 26

If there is pain walking uphill, is that vascular or neurogenic claudication?

Answer 26

Vascular

Question 27

What is the diameter of normal spinal cord? Diameter of normal spinal canal?

Answer 27

Spinal cord = 10mm

Spinal canal = 17mm

Question 28

What kind of exercises do you prescribe for vertebral body compression fracture

Answer 28

Hyperextension exercises

Question 29

If spondylolisthesis is congenital, what type/class is it?

Answer 29

Dysplastic (class I)

Question 30

In lumbar scoliotic curves, what direction is the most common?

Answer 30

Left lumbar curves > right lumbar curves

Question 31

How much of a decrease in vertebral height after a compression fracture do you recommend surgery?

Answer 31

50%

Question 32

What vertebral level most commonly has spondylolysis?

Answer 32

L5

Question 33

Most common type of scoliosis

Answer 33

Idiopathic

Question 34

What type of exercises do you do for spondylolisthesis

Answer 34

Flexion-biased position exercises

Question 35

What type of brace do you use for spondylolisthesis?

Answer 35

TLSO brace

Question 36

Most common scoliotic curve pattern

Answer 36

Right thoracic curve

Question 37

What kind of brace do you prescribe for vertebral body compression fractures?

Answer 37

TLSO/Jewett hyperextension brace