Scoliosis

Question 1

Curvature within the frontal (coronal) plane >10 degrees with vertebral rotation noted on x-ray

Answer 1

scoliosis

Question 2

What are the 3 types of scoliosis?

Answer 2

1. idiopathic
2. congenital
3. neuromuscular - deformity results from the loss of motor control

Question 3

Which side is scoliosis named for?

Answer 3

side of convexity

Question 4

What type of scoliosis cannot be voluntarily, passively, or forcibly fully corrected, vertebrae rotate toward the convex side and there is a fixed rib hump on clinical exam

Answer 4

Structural scoliosis

Question 5

What type of scoliosis fully corrects clinically and radiographically on lateral bend toward the apex of the curve and lacks vertebral rotation, is non-progressive, and is usually caused by a leg length discrepancy

Answer 5

Nonstructural scoliosis

- Shorter LE=Convex side of curve

Question 6

Infantile idiopathic scoliosis:

• Occurs in children under __
• <1% of cases in North America
• Males>Females
• Primarily ___ curvature
• _______ resolution in 80-90%

Answer 6

• 3
• left
• Spontaneous

Question 7

Juvenile idiopathic scoliosis:

• Occurs between ___ years of age
• Commonly _________ curvature
• High rate of progressive deformity if left untreated

Answer 7

• 3-9

- right thoracic

Question 8

Adolescent idiopathic scoliosis:

• Onset around age of
• __% of all cases of idiopathic scoliosis are adolescent-onset
• Female:Male prevalence is 3.6:1
• Typically ____ type curve at detection

Answer 8

• puberty
• 80
• structural

Question 9

There are two types of NM scoliosis, neuropathic and spinal MD. What is the difference between the two?

Answer 9

1. Neuropathic = Result of an UMN lesion
   - Prevalence is 60% among those with Myelomeningocele (spina bifida)
   - Prevalence is 25% among those with CP
2. Spinal Muscular Dystrophy = Result of a LMN lesion; Frequent complication secondary to muscular dystrophies, spinal muscular atrophy, or spinal cord injury in children (90-100% of cases)

Question 10

When is a referral for further evaluation warranted if there is a rib hump present?

Answer 10

if 5-7 degree rib hump is detected

Question 11

What does the risser sign need to be in order for PT to have an impact?

Answer 11

0 or 1

- If a 4 or 5, there will be minimal impact via PT

Question 12

When is nonsurgical intervention appropriate to treat scoliosis?

Answer 12

1. Idiopathic curves <25 degrees
2. Skeletally immature patient (Risser grade<2)
3. Non-progressive congenital curves
   - effectiveness of bracing and exercise is promising but not yet established

Question 13

What kids of exercises would be included for intervention?

Answer 13

1. Improve core strength and flexibility/range of motion
2. Balance activities, if indicated
3. Respiratory activities
4. Spinal Stabilization Exercises

Question 14

What outcome is considered successful for PT intervention?

Answer 14

if progression is limited to 5 degrees or less

Question 15

When is surgery indicated?

Answer 15

1. Cobb angle >40-45 degrees
2. Curve progression during conservative management
   - bracing is worn 9-12 months after surgery
   - PT needed for bed mobility, transfers, dressing, breathing, ROM, strength and ambulation
   - trunk rotation is CONTRAINDICATED post-op