Spine

Question 1

In infantile scoliosis, a Cobb angle of what is associated with progression?

Answer 1

> 20 DEGREES

Question 2

What two types of infantile scoliosis are there?

Answer 2

Resolving type and progressing type

Question 3

What advanced imaging needs to be obtained in infantile scoliosis and why?

Answer 3

MRI; rule out syrinx, tethered cord, cyst or tumor

Question 4

What genetics are associated with infantile scoliosis?

Answer 4

Autosomal dominant with variable penetrance

Question 5

What is thoracic insufficiency syndrome?

Answer 5

Characterized by decreased thoracic growth and lung volume

Question 6

In infantile scoliosis, pulmonary function impairment is associated with curves above what degree?

Answer 6

> 60 degrees

Question 7

In infantile scoliosis, cardiopulmonary issues are associated with curves above what degree?

Answer 7

90 degrees

Question 8

In infantile scoliosis, what foot deformity can be seen on exam?

Answer 8

cavovarus

Question 9

Abnormal abdominal reflexes is associated with what in the setting of infantile scoliosis?

Answer 9

Presence of a syrinx

Question 10

A Cobb angle greater than what degree is associated with progression of a curve in infantile scoliosis?

Answer 10

> 20 degrees

Question 11

A rib vertebral angle difference (RVAD) greater than what degree is associated with curve progression in infantile scoliosis?

Answer 11

> 20 degrees is linked to a high rate of progression; <20 degrees is associated with spontaneous recovery

Question 12

What are the indications for nonoperative management of infantile scoliosis?

Answer 12

Cobb angle <30 degrees; RVAD <20 degrees; 90% will resolve spontaneously

Question 13

What are the indications for serial Mehta casting in infantile scoliosis?

Answer 13

Cobb >30 deg, flexible curve, RVAD >20 deg, phase 2 rib-vertebrae relationship (rib-vertebral overlap)

Question 14

What are the indications for growing rod constructs in infantile scoliosis?

Answer 14

Cobb >50 deg to 60 deg

Question 15

Spinal fusion before what age results in pulmonary compromise?

Answer 15

Fusion before age 10

Question 16

What pulmonary function tests are improved with growing rod constructs?

Answer 16

FVC

Question 17

Herniated discs are associated with a sudden increase in what factors?

Answer 17

Osteoprotegrin, interleukin-1 beta, RANKL, and PTH

Question 18

What are the risk factors for nonunions in patients with type II odontoid fractures?

Answer 18

Fracture gap >1 mm; delay in treatment >4 days; posterior displacement >5 mm; posterior displacement after application of halo vest of >2 mm

Question 19

How many pins are used for adult halo pin placement?

Answer 19

4 pins

Question 20

How many pins are used for pediatric halo pin placement?

Answer 20

6-8

Question 21

What is the torque for adult halo pins?

Answer 21

8in-pounds of torque

Question 22

What is the torque for pediatric halo pins?

Answer 22

lower than adults - 2-4in pounds of torque (finger tight)

Question 23

What is the most common nerve injured in halo orthoses?

Answer 23

Abducens (CN VI); loss of lateral gaze on affected side

Question 24

BMP-2 is FDA approved for which spine procedure?

Answer 24

Single-level ALIF