Exam 2: Scoliosis

Question 1

Curves less than ___ degrees are just postural changes

Answer 1

10 degrees

Question 2

If curve is greater than 10 degrees, and is accompanied by vertebral rotation it is called

Answer 2

Scoliosis

Question 3

___% of cases are idiopathic

Answer 3

80

Question 4

MC scoliosis

Answer 4

Right thoracic

Question 5

Functional scoliosis

Answer 5

Caused by postural problem, muscle spasm, or leg-length inequality

Question 6

Structural scoliosis

Answer 6

Bony distortion

Question 7

Which type of scoliosis can often be addressed

Answer 7

Functional

Question 8

Scoliosis affects how many people in US

Answer 8

5-7 million

Question 9

Scoliosis most often develops between ages

Answer 9

10-15

Question 10

Boys or girls most commonly affected?

Answer 10

Girls

Question 11

Can scoliosis be inherited?

Answer 11

Yes, those w/ parents or siblings who have it should be evaluated

Question 12

Prevalence in kids 10-16 years old

Answer 12

2-4%

Question 13

Ratio of girls to boys having a curve greater than 30 degrees

Answer 13

10:1

Question 14

What population of young girls are at highest risk

Answer 14

Scoliosis greater than 25 degrees, but haven’t had 1st menstrual period

Question 15

Risser grades

Answer 15

1 = 25%
2 = 50%
3 = 75%
4 = 100%
5 = skeletal maturity

Question 16

Low risk of progression

Answer 16

5-15%

Question 17

Moderate risk of progression

Answer 17

15-40%

Question 18

High risk of progression

Answer 18

40-70%

Question 19

Very high risk of progression=

Answer 19

70-90%

Question 20

Curve and Risser sign associated with a high risk of progression

Answer 20

20-29 degrees w/ 0/1 Risser sign

> 29 degrees w/ 2-4 Risser sign

Question 21

Curve and Risser sign associated w/ very high risk of progression

Answer 21

> 29 degrees w/ 0-1 Risser sign

Question 22

Scoliosis develops in 2 stages

Answer 22

Curve initiation

Curve progression

Question 23

Hueter-Volkmann Law

Answer 23

Bone growth before skeletal maturity is stunted by mechanical compression on growth plate; and is accelerated by growth plate tension

Question 24

Treatment options

Answer 24

Careful observation
Bracing
Surgery

Question 25

Most common treatment option

Answer 25

Careful observation

Question 26

T/F: most scolioses do not progress and cause few, if any, physical problems

Answer 26

True

Question 27

Bracing is generally used on kids who

Answer 27

1. Have not reached skeletal maturity | 2. Curves btw 25-45 degrees

Question 28

Surgery is used in cases where

Answer 28

Curves are >45 degrees and are progressive Function of vital organs are affected

Question 29

Chiropractic interventions

Answer 29

Adjustments | Exercises and EMS

Question 30

American Academy of Ortho Surgeons recommends screening girls and boys

Answer 30

Girls = 2x (ages 10 and 12) Boys = 1x (age 13 or 14)

Question 31

American Academy of Pediatrics recommends screening kids at ages

Answer 31

10, 12, 14, and 16

Question 32

Adam’s Forward Bend Test

Answer 32

Patient asked to bend 90 degrees at waist Examiner can view asymmetry of trunk/spinal curvatures

Question 33

Screening hints

Answer 33

``` Shoulders different heights Head not centered over pelvis Prominent hip/uneven waist Rib cages diff heights Changes in overlying skin Leaning of body ```

Question 34

Cobb angle of ___ degrees defines scoliosis

Answer 34

10

Question 35

Moderate curves (20-40 degrees) are treated w/

Answer 35

Patient and bracing

Question 36

MC brace used to treat scoliosis

Answer 36

Boston Brace Thoraco-lumbar-sacral orthosis (TLSO)

Question 37

Milwaukee brace

Answer 37

Similar to Boston Brace, but includes neck ring CTLSO

Question 38

Braces have ___% success rate at halting curve progression

Answer 38

74%

Question 39

Bracing does NOT ____ but may ____

Answer 39

Correct scoliosis; may prevent serious progression

Question 40

Braces usually recommended to be worn ___ hours per day

Answer 40

23 is optimal (but at least 16)

Question 41

Curves in growing children greater than __ degrees require spinal fusion

Answer 41

40 degrees

Question 42

Skeletally mature patients can be observed until their curves reach

Answer 42

50 degrees

Question 43

Thoracic scoliosis surgery results in loss of

Answer 43

Kyphosis (also lumbar lordosis over time)

Question 44

5-7 years post-surgery 1/5-1/3 of patients experienced

Answer 44

LBP and disc degeneration below fusion