Spine Flashcards
In infantile scoliosis, a Cobb angle of what is associated with progression?
> 20 DEGREES
What two types of infantile scoliosis are there?
Resolving type and progressing type
What advanced imaging needs to be obtained in infantile scoliosis and why?
MRI; rule out syrinx, tethered cord, cyst or tumor
What genetics are associated with infantile scoliosis?
Autosomal dominant with variable penetrance
What is thoracic insufficiency syndrome?
Characterized by decreased thoracic growth and lung volume
In infantile scoliosis, pulmonary function impairment is associated with curves above what degree?
> 60 degrees
In infantile scoliosis, cardiopulmonary issues are associated with curves above what degree?
90 degrees
In infantile scoliosis, what foot deformity can be seen on exam?
cavovarus
Abnormal abdominal reflexes is associated with what in the setting of infantile scoliosis?
Presence of a syrinx
A Cobb angle greater than what degree is associated with progression of a curve in infantile scoliosis?
> 20 degrees
A rib vertebral angle difference (RVAD) greater than what degree is associated with curve progression in infantile scoliosis?
> 20 degrees is linked to a high rate of progression; <20 degrees is associated with spontaneous recovery
What are the indications for nonoperative management of infantile scoliosis?
Cobb angle <30 degrees; RVAD <20 degrees; 90% will resolve spontaneously
What are the indications for serial Mehta casting in infantile scoliosis?
Cobb >30 deg, flexible curve, RVAD >20 deg, phase 2 rib-vertebrae relationship (rib-vertebral overlap)
What are the indications for growing rod constructs in infantile scoliosis?
Cobb >50 deg to 60 deg
Spinal fusion before what age results in pulmonary compromise?
Fusion before age 10
What pulmonary function tests are improved with growing rod constructs?
FVC
Herniated discs are associated with a sudden increase in what factors?
Osteoprotegrin, interleukin-1 beta, RANKL, and PTH
What are the risk factors for nonunions in patients with type II odontoid fractures?
Fracture gap >1 mm; delay in treatment >4 days; posterior displacement >5 mm; posterior displacement after application of halo vest of >2 mm
How many pins are used for adult halo pin placement?
4 pins
How many pins are used for pediatric halo pin placement?
6-8
What is the torque for adult halo pins?
8in-pounds of torque
What is the torque for pediatric halo pins?
lower than adults - 2-4in pounds of torque (finger tight)
What is the most common nerve injured in halo orthoses?
Abducens (CN VI); loss of lateral gaze on affected side
BMP-2 is FDA approved for which spine procedure?
Single-level ALIF