Scoliosis - Structural

Question 1

Define scoliosis

Answer 1

Any lateral deviation of the spine greater than 10 degrees from the vertical line of the spine

Question 2

How many degrees must the angle be to qualify as scoliosis?

Answer 2

10 degrees

Question 3

Sidebending and rotation are (not related, sometimes related, or coupled motions)

Answer 3

coupled motions

Question 4

The vast majority follow type 1 or type 2 Fryette mechanics?

Answer 4

type 1

Question 5

How is scoliosis named?

Answer 5

for the side of convexity; If the person is sidebent left they have a right scoliosis

Question 6

Does all asymmetry require treatment?

Answer 6

No

Question 7

List 3 common ways scoliosis presents

Answer 7

routine physical exam, sudden onset, trauma

Question 8

Pain in scoliosis suggests…

Answer 8

that the scoliosis is due to pain (not scoliosis causing pain)

Question 9

Scoliosis could be the result of…

Answer 9

fracture, spondylolisthesis, nerve entrapment, spinal cord impingement

Question 10

During a physical examination what two static and one dynamic structural exams must be completed?

Answer 10

Static - mid-gravity, symmetry

Dynamic - forward bending (Adam’s test)

Question 11

If a rib hump measures more than ______ degrees further evaluation is warranted.

Answer 11

7 degrees

Question 12

Why is such a small degree of concern?

Answer 12

Can impair pulmonary ventilation

Question 13

A neurologic deficit would be caused by scoliosis. (T/F)

Answer 13

False

Question 14

Why would you get an MRI for an idiopathic scoliosis?

Answer 14

looking for conditions like syringomyelia, neurofibromatosis which can mimic idiopathic scoliosis

Question 15

How would you rule out Marfan or Ehlers-Danlos syndrome?

Answer 15

examine extremities for arachnodactyly and joint laxity

Question 16

List the curve patterns and typing.

Answer 16

C- shaped, S-shaped, complex; major, minor, double major

Question 17

What must be considered in scoliosis management?

Answer 17

age, skeletal maturity, type of curve, severity of curve, duration of curve, complicating factors

Question 18

What is the most likely cause of scoliosis in an infant? (0-3 years of age)

Answer 18

congenital (ex. hemivertibrae)

Question 19

In juvenile cases (3-10) what percent are due to occult intraspinal anomaly?

Answer 19

20%;

Question 20

If scoliosis appears in adulthood it is usually associated with what?

Answer 20

disease

Question 21

How does the area of the scoliotic curve affect the treatment?

Answer 21

Thoracolumbar is the most severe and surgery is considered at 40 degrees. Thoracic at 55 degrees.

Question 22

What 7 complicating factors need to be evaluated in the decision?

Answer 22

pulmonary compromise, cardiac compromise, neurologic compromise, progression of curve, degenerative spondylosis, pelvic distortion, collapse of curve

Question 23

Curves greater than ____ degrees are at increased risk for shortness of breath.

Answer 23

50 degrees

Question 24

Curves greater than ____ degree Cobb angle impair respiratory function and venous return.

Answer 24

70 degrees

Question 25

Neurologic deficits can signal what diseases?

Answer 25

spinal cord or cauda equine compression

Question 26

Curve collapse can result from _______ and abnormal _______ ________ test.

Answer 26

trauma; liver function

Question 27

What are the 4 common etiologies of structural scoliosis?

Answer 27

neurologic, congenital, connective tissue disease, idiopathic

Question 28

Which neurologic causes of scoliosis are reversible?

Answer 28

Chiari malformations, neurofibromatosis, and tethered spinal cord

Question 29

What neurologic causes of scoliosis are nonreversible?

Answer 29

cerebral palsy, muscular dystrophy (myopathic)

Question 30

How would you treat Chiari malformations?

Answer 30

surgical decompression of malformation due to congenital deformities of brain stem and upper spinal cord

Question 31

How would you treat Neurofibromatosis?

Answer 31

remove the benign tumors impinging on spinal cord or nerve roots

Question 32

How might you treat a scoliosis caused by an irreversible disease?

Answer 32

surgical fusion of spine

Question 33

What does a “Scoliscore” accomplish?

Answer 33

Genetic screening test used in 9-13 years olds can predict the likelihood that a curve 40 degrees.

Question 34

In a compensatory curve the curve will straighten on forward bending. (T/F)

Answer 34

True

Question 35

Treatment for idiopathic scoliosis

Answer 35

OMT, exercise, bracing, traction, implantable paraspinal electrical stimulator, surgical fusion

Question 36

Exercise helps maintain __________ of the spine leading to better outcomes of bracing and surgery.

Answer 36

mobility

Question 37

How do you determine when to go to surgery?

Answer 37

At the end of bone growth using Risser Scale.

Question 38

What apophyses does the Risser scale look at to determine fusion?

Answer 38

iliac crest apophyses

Question 39

Stage the Risser Signs

Answer 39

1 - front near ASIS
2 - Midway to PSIS
3 - 3/4 to PSIS 
4 - to PSIS
5 - Complete fusion (takes 12-36 months)

Question 40

Surgical technique that allows for preservation of sagittal plane, spinal curves

Answer 40

Pedicle screws and contoured rod

Question 41

What is sesquipedality?

Answer 41

practice of using long words