Chapter 26- Spinal deformity Flashcards
Primary causes of scoliosis
- idiopathic
- Paralytic: poliomyelitis
- Congenital (vertebral anomaly)
- Neurofibromatosis
Secondary causes of scoliosis
- Postural: adolescents
- Compensatory: Short leg or pelvic tilt due to hip contracture
- Sciatic: Lateral tilt with pain due to disc herniation
effect of scoliosis on the patient
- cosmetic/ psychological
- respiratory impairment
- pain
- neurological deficit
Screening test for scoliosis
Adam’s test
Treatment of idiopathic scoliosis in growing child
<25 degrees: Xray 4 monthly and if progression, consider corrective brace until maturity
25- 50 degrees: offer brace or surgical correction
> 50 degrees: Corrective spinal fusion
Treatment of idiopathic scoliosis after completion of growth
Surgery: instrumentation and fusion if poor cosmesis, respiratory impairment or pain
causes of kyphosis
- congenital: vertebral anomalies
- traumatic: wedge compression fracture
- infective: TB spondylitis
- inflammatory: ankylosing spondylitis
- Neoplastic: pathological fracture from tumor infiltration
- metabolic: osteoporosis
- miscellaneous: scheurmanns disease, neurofibromatosis, neuromuscular paralytic conditions
effects of kyphosis
- Respiratory impairment
- Cosmesis
- pain
- paraplegia
treatment of congenital kyphosis
early spine fusion
treatment of active TB spondylitis
- Anti-TB drugs for 9- 12 months
- Evacuation of the spinal abcess and reconstruction
Treatment of healed TB spondylitis
Surgical decompression and reconstruction
treatment of neoplastic causes of kyphosis
-confirm diagnosis with needle or open biopsy
Benign: excision, possibly spine fusion
Malignant: surgery and/or irradiation
Treatment of metabolic cause of kyphosis (osteoporosis)
rest, analgesia
DEXA scan
Calcium, vitamin D, bisphosphanates
