Scoliosis Flashcards
What is the normal curvature C and L spines?
Lordosis
What is the normal curvature of T spine?
Khyphosis
What is Scoliosis?
Abnormal curve, primarily in coronal plane
Scoliosis is named for the side of _.
convexity
What are some classification of scoliosis?
- Idiopathic
- congenital
- acquired
- neuromuscular (ms imbal and lack of trunk control)
- syndromic
In what gender is infantile idopathic scoliosis more common?
Male
In infantile idiopathic scoliosis, what is the common scoliosis (left or right) and what region of spine
Convex to L and curve usually thoracolumbar
85% of infantile scoliosis clases resolve spontaneously, but if curve gets greater than what degree should you refer to ortho?
35
This type of idiopahtic scoliosis, most progress steadily and occasionally quiescent then become progressive and needs to be referred to ortho if Cobb angle reaches greater than 20 degrees.
Juvenile idiopathic scoliosis
what is the most common idiopathic scoliosis?
Adolescent idopathic scoliosis (80-85% of cases)
In dolescent idophatic scoliosis, incidence is amost equal betwen male and female, but progression to injury is more common in which gender/
female. (F 8.1: M 1.0)
What is the prevalence of curve type in adolescent idopathic scoiosis?
Most common - double major: right thoracic and left lumbar
What are some causes of congenital scoliosis?
Failure of formation (wedge vertabrae, hemivertbarae)
Failure of segmentation (unilateral unsegmentaed bar, bilateral (blck vertbrae)
With congenital scoliosis, what other anomalies are likely to seen?
Urinary tract
Cardiac
spinal dysraphism
What is the progression rate of congenital scoliosis?
50% progesses and will need surgery. 25% will not progress and another 25% will progess slightly but will not need surgery
Why is surgery a concern in congenital scoliosis?
- Problem will not go away
- bracing not effective (cannot correct a structural deformity)
- Surgery can alter vertical growht
What are some neuromuscular causes of scoliosis?
Cerebral palsy
Polio
Duchenne’s muscular dystrophy
What are some syndromic causes of scoliosis?
- Marfan’s
- Ehler Danlos
- Neurofibromatosis
when screening, what are some things you you can check for scoliosis?
-level of hips
-arm length
-bulge on back
-lean to side
-prominence of scapula (superior and inferior borders)
-shoulder height difference
-crease at waist
-iliac crests
leg length
What is Adam’s forward bend test
Indicates rotational component.
Asymmetry is noted on the side of the convexity
beyond what degree does Cobb consider scoliosis?
10 degree
How do you measure cobb’s angle?
Most cephalad vertebra whose superior surface angles INTO the curve
Most caudal vertebra whose inferior surface angles INTO the curve. Draw right angles to both these lines. Where they cross is Cobbs angle.
WHat are some indications for Ortho referral?
- Cobb angle greater than 20
- progression of Cobb angle >5 deg
- Some will make referral for baseline eval for Cobb greater than 10 degrees
How would you treat idiopathic scoliosis of 0-10 degrees, asymptomatic, in skeletally immature pt.
- OMT
- Observation with follow up (every 4-6 mos) if curve increase > 5 degrees refer to ortho
