Chapter 5 Scoliosis and Short Leg Syndrome

Question 1

Epidemiology of scoliosis?

Answer 1

5% of school-aged children develop it before 15

Question 2

Percentage of children with actual sxs related to their scoliosis?

Answer 2

10%

Question 3

Female: Male ratio for scoliosis?

Answer 3

4:1

Question 4

Dextroscoliosis?

Answer 4

Curve that is SB left = scoliosis to the right

Question 5

Levoscoliosis?

Answer 5

Curve that is SB right = scoliosis to the left

Question 6

2 types of scoliosis curves?

Answer 6

1) Structural curve

2) Functional curve

Question 7

Which curve is fixed and inflexible?

Answer 7

Structural

Question 8

Which curve will NOT correct with sidebending in opposite direction?

Answer 8

Structural

Question 9

Which is assoc with vertebral wedging and shortened ligaments/musccles on concave side?

Answer 9

Structural

Question 10

T/F An uncorrected functional curve may progress to a structural curve?

Answer 10

True

Question 11

When should kids be screened?

Answer 11

10-15 years

Question 12

What is the angle measures the degree of scoliosis?

Answer 12

Cobb angle

Question 13

What is Cobb angle?

Answer 13

Draw horizontal line from vertebral bodies of extreme ends of curve; then draw perpendicular lines from these horizontal lines

Question 14

At what angle is respiratory function compromised?

Answer 14

> 50

Question 15

At what angle is cardiac function compromised?

Answer 15

> 75

Question 16

What are the causes of scoliosis?

Answer 16

Idiopathic, congenital, neuromuscular, acquired

Question 17

Which type is most often progressive?

Answer 17

Congenital

Question 18

What are Konstancin exercises?

Answer 18

A series of specific exercises that has been proven to improve the pt with scoliotic postural decompensation

Question 19

When is bracing indicated?

Answer 19

Moderate scoliosis

Question 20

When i surgery indicated?

Answer 20

Severe scoliosis–if there is resp compromise or if it progresses despite conservative management

Question 21

3 things that cause short leg?

Answer 21

1) Sacral base unleveling
2) Vertebral SB and rotation
3) Innominate rotation

Question 22

Most common cause of anatomical short leg?

Answer 22

Hip replacement

Question 23

First ligament to be stressed in short leg?

Answer 23

Iliolumbar ligaments, then the SI ligaments

Question 24

Sacral base unleveling compensation?

Answer 24

Sacral base will be lower on short leg side

Question 25

Innominate compensation?

Answer 25

Anterior rotation on short leg side; posterior rotation on long leg side

Question 26

Lumbar spine compensation?

Answer 26

SB away, rotate toward short leg side

Question 27

Lumbosacral (Ferguson's) angle compensation?

Answer 27

Increased 2-3 degrees

Question 28

How to quantify differences in heights of femoral head for short leg syndrome?

Answer 28

Standing x-ray

Question 29

When to consider heel lift?

Answer 29

Femoral head difference >5mm

Question 30

When should the full lift be administered?

Answer 30

Sudden onset of discrepancy (e.g. fracture, surgery)

Question 31

What should the final lift height be?

Answer 31

1/2 - 3/4 of measured leg length discrpancy

Question 32

What should the "fragile" pt begin with?

Answer 32

1/16" (1.5mm) and increase 1/16" every 2 weeks

Question 33

What should the "flexible" pt begin with?

Answer 33

1/8" (3.2mm) and increase 1/8" every 2 weeks

Question 34

What is the max height that can be applied to INSIDE the shoe?

Answer 34

1/4"

Question 35

What if >1/4" is needed?

Answer 35

Apply to OUTSIDE of shoe

Question 36

What is maximum heel lift possible?

Answer 36

1/2"

Question 37

How do you prevent pelvis from rotating to opposite side when >1/2" lift is needed?

Answer 37

Apply an ipsilateral anterior sole lift extending from heel to toe

Question 38

Most common cause of scoliosis?

Answer 38

Idiopathic