Spinal deformities Flashcards
What is scoliosis defined as?
A lateral curvature of the spine ≥ 10 degrees, typically accompanied with a variable degree of vertebral rotation.
What are the types of idiopathic scoliosis based on age?
- Infantile (0-3 yrs)
- Juvenile (4-10 yrs)
- Adolescent (11-17 yrs)
- Adult (≥18 yrs)
What are the congenital causes of scoliosis?
- Present at birth
- Failure of formation (Hemivertebra)
- Failure of segmentation (congenital fusion)
- Associated genitourinary deformities
What neuromuscular conditions can lead to scoliosis?
- Cerebral palsy
- Myelomeningocele
- Myopathies
- Muscular dystrophies
- Trauma
What syndromic disorders are associated with scoliosis?
- Marfan’s
- Neurofibromatosis
- Osteogenesis imperfecta
What is the prevalence of adolescent idiopathic scoliosis (AIS)?
2-4% of all adolescents.
What is the male to female ratio for adolescent idiopathic scoliosis?
5 Females > 1 Male.
What family history factor increases the risk for scoliosis?
Family history increases risk up to 7 times.
What are some associated symptoms to inquire about in a scoliosis history?
- Pain
- Weakness
- Stiffness
- Breathing issues
What is the importance of the Adam’s forward bending test?
To assess for prominent rib hump indicative of scoliosis.
To differentiate between functional (symmetrical when bending forward) and structural scoliosis (Asymmetrical when being forward)
What are the three treatment options for scoliosis?
- Observation
- Bracing
- Surgical correction
What is the indication for bracing in scoliosis treatment?
Idiopathic curve > 25° and skeletally immature (Risser <4 in boys or <5 in girls).
What are the goals of surgical intervention in scoliosis?
- Deformity correction
- Stop progression
What is Scheuermann’s Kyphosis?
A deformity of the thoracic or thoracolumbar spine with increased kyphosis, backache, and localized changes in vertebral bodies.
Typically affects adolescents, between 12 to 16 y/o.
IT IS A DEVELOPMENTAL DISORDER IN ADOLESCENTS.
What is the prevalence range of Scheuermann’s Kyphosis?
0.4-8%.
What are the indications for surgery in Scheuermann’s Kyphosis?
- Kyphosis progression despite conservative treatment
- Painful thoracic kyphosis > 70-80°
- Thoracolumbar kyphosis > 40°
What are the Sorenson criteria for diagnosing Scheuermann’s Kyphosis?
- 3 consecutive wedged vertebrae of >5°
- Secondary changes like Schmorl nodes
- Irregular endplates
- Disk space narrowing
What are some differential diagnoses for kyphosis?
- Postural kyphosis
- Congenital kyphosis
- Posttraumatic kyphosis
- Post-TB kyphosis
- Neurofibromatosis
What conservative treatments are recommended for Scheuermann’s Kyphosis?
- Physiotherapy
- Bracing
- Pain medication
What is the typical presentation of a patient with Scheuermann’s Kyphosis?
Progressive deformity, neurologic compromise, cardiopulmonary complaints, and cosmetic issues.
What are the common clinical findings in Scheuermann’s Kyphosis?
- Fixed or partial structural kyphotic deformity
- Compensatory lumbar hyperlordosis
