Scoliosis and Spinal deformity Flashcards

1
Q

what causes the vast majority of scoliosis

A

idiopathic

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2
Q

describe the deformity in scolisosi

A

complex- rotational component, lateral bend component, rib deformities, visceral abnormalities

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3
Q

what are the four types of scoliosis

A

congenital (developmental abnormality)
early onset idiopathic
late onset idiopathic
secondary

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4
Q

what are the 4 commonest subtypes of congenital scoliosis

A

wedge vertebrae (unilateral partial failure of formation)

unilateral bar (+/- hemivertibrae) (unilateral failure of segmentation)

hemivertebra (unilateral complete failure of formation- can be fully segmented, semisegmented and incarcerated)

block vertebra (bilateral failure of segmentation)

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5
Q

what is the common theme amongst congenital scoliosis

A

imbalance in the number of growth plates- the greater the imbalance the greater the potential deformity

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6
Q

can early onset idiopathic correct itself

A

sometimes

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7
Q

what can cause a secondary scoliosis

A

neuromuscular
tumours
spina bifida

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8
Q

what is the non operative management of scoliosis

A

serial corrective casts
bracing
corrective exercises
electrical stimulation

(often disappointing results)

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9
Q

what should be taken into account before deciding about surgery

A

rate of deterioration
functional level
life expectancy
general condition

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10
Q

what surgery can sometimes treat effectively a short segment thoracolumbar scoliosis

A

anterior surgery (one stage surgery)

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11
Q

what type of deformity might need a combined (anterior and posterior) surgery (as staged procedures)

A

complex, fixed deformities

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12
Q

name two other deformities of the spine exuding scoliosis

A

kyphosis

spondylolisthesis

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13
Q

describe a kyphosis deformity

A

centre of gravity anterior to the spine
high pre load
may be opposite of scoliosis

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14
Q

what is spondylolysis

A

defect in the pars interarticularis of the vertebra

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15
Q

what is spondylolisthesis

A

the forward slippage of one vertebra on another

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16
Q

what is meyerding

A

grading of severity of spondylolisthesis (quarters, grades 1-4, grade 5 is spondyloptosis)

17
Q

what is spondyloptosis

A

100% subluxation of a superior vertebral body on an inferior one

18
Q

when should surgical treatment of spondylolysis/listhesis be considered

A

when conservative treatment has failed
adolescent with >50% slip
progressive neurological deficit
postural deformity

19
Q

what is a grade 1 or 2 spondylolisthesis

A

abnormal neighbouring discs

posterolateral stabilisation in situ

20
Q

what is a grade 3 spondylolisthesis

A

combined discogenic + nerve root problem

one stage combined anterior and posterior stabilisation