Scoliosis

Question 1

Adolescent

Answer 1

10-18
Rt thoracic 
Mx: 
- cobb <25 observe
- 25-45; flexible ; immature = brace 
->45 surgery ; PSF (level , end vertebrae proximal to 2 level below stable one )

Question 2

Indication of MRI

Answer 2

Atypical curve 
Foot deformity 
CNS symptoms 
Rapid progression 
Asymmetrical abdominal reflex

Question 3

Juvenile

Answer 3

4-10 
Rt thoracic
 Do MRI r/o neural axis abnormalities 
Mx: 
- <20 observe 
- 20-50 brace 
->50 growing rod / VEPTR

Question 4

Infantile

Answer 4

Less than 3 y/o
Left thoracic
 MRI: r/o tether cyst tumor syrinx
Mx ; 
- cobb <30 , RVAD <20 ; observe 
- cobb >30 , RVAD >20 , phase 2 rib ; Mehta cast
- >50 growing rod

Question 5

CongntiaL

Answer 5

Renal , cardic , VACTERL
MRI to all pt
Failure of formation or segmentation
Mx ;
PSF +/- osteotomy: hemi vertebrae neuro deficit
Anterior+ PSF : young pt
Osteotomy between ribs : 4 fused + thoracic insufficiency syndrome

Question 6

Type of vertebrae

Answer 6

End vertebrae: most tilited
Apical : اكثر واحده حاذفه
Neutral : no rotation “ pedicle”
Stable : first one to be bisected by central sacral vertical line

Question 7

Kyphosis

Answer 7

<60 observe
60-80 Brace
>80 SPO PSF