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SPINAL > Scoli (Quiz 3) > Flashcards

Scoli (Quiz 3) Flashcards

1
Q

Idiopathic

A

relating to or denoting any disease or condition that arises spontaneously or for which the cause is unknown

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2
Q

idiopathic scoliosis

A

lateral curvature of the spine equal or greater then 10 degrees in the absence of any congenital spinal anomaly or associated musculoskeletal condition

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3
Q

Early/Late Onset Scoliosis

A

Infantile onset (0-3)
Juvenile (4-10)

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4
Q

When does adolescents end

A

when great plates fuse (skeletal maturity)

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5
Q

Goals of idiopathic scoli treatment

A

reduce RVAS; phase rotation
decrease curve magnitude
improve balance
prevent surgery
prevent cardiopulmonary decline

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6
Q

Dr Mehta contributions

A

Gold standard serial casting protocol

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7
Q

Phase I rotation

A

apical rib head does not overlap vertebrae

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8
Q

Phase II rotation

A

apical rib head does overlap apical vertebra

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9
Q

Resolving Curve Progression

A

RVAD <20 degrees phase I

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10
Q

Progressive Curve Progression

A

RVAD > 20 degrees phase II

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11
Q

Clinical considerations orthotic management of infantile scoliosis

A

rapid growth
rip deformation

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12
Q

Orthotic options for Infantile scoli

A

custom TLSO
lined/framed TLSO
milwuakee

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13
Q

Casting Technique sequence

A

derotate
gentle stretch
elongate
correct coronal plane deformity

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14
Q

Juvenile Idiopathic Scoliosis

A

4 years to 10 years
similar to adolescent curve type and orthotic management

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15
Q

AIS Etiology

A

unknown

theories (biomechanics, nutritional deficiency, structural, endocrine, genetic)

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16
Q

what to look for to determine stage of skeletal growth

A

risser sign
age
triradiate cartilage
menarche
tanner

17
Q

Risser Sign

A

based on location of apophyseal plate
orthotic management best to start at Risser 0
usually weaning out of orthosis around risser 3, 4

18
Q

What curves are most likely to progress

A

thoracic and double curves are more likely to progress compare to thoracolumbar or lumbar curves

19
Q

what is the greatest risk for curve progression

A

rapid skeletal growth

20
Q

Treatment of AIS Observations

A

curve <20 degrees
skeletally mature
exercise

21
Q

pedicle rotation

A

rotation goes toward concavity

22
Q

treatment of AIS orthotic treatment

A

curves 25-45 degrees
curves 20-25 (with documented progression; gross asymmetry; open triradiates; genetic presdisposition)

23
Q

AIS Treatment Goals

A

change natural history further curve progression
avoid surgery

24
Q

How do we achieve goals

A

reduce “inbrace” curve magnitude
educate patient/family on proper wearing schedule
targeting the primary adolescent growth spurt

25
Q

How are critical load (spinal stability) and degree of curvature related?

A

inversely related

26
Q

What apex do you suggest a CTLSO

A

T7 or above

27
Q

What brace was more effective when controlling thoracic or double curves

A

Boston Brace

28
Q

What brace was more effective in controlling lumbar curves

A

charleston brace

29
Q

BRAIST Study Results

A

75% of subjects that wore an orthosis did not require surgery compared to only 42% in the observation group

30
Q

BRAIST Study Primary Conclusions

A

orthotic management significantly decreased progression in high risk curves

gains in benefit were seen with increasing hours of brace wear

31
Q

Biomechanic principles

A

reduce deforming moment
balance (all three planes)
management of cobb angle
three point pressure system

32
Q

Greatest influence on patient compliance regarding wearing of the orthosis

A

difficult paying attention in school
emotional about having to wear orthoses
problems eating
difficulty sitting

33
Q

Functional Scoliosis

A

when the patient appears to have a curve in their spine but it is actually caused by another condition

34
Q

Possible causes of Functional Scoliosis

A

LLD, muscle spasm, chronic bad posture

35
Q
A

SPINAL (9 decks)

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