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OMM Lecture > Lumbar IV/ Group Curves > Flashcards

Lumbar IV/ Group Curves Flashcards

1
Q

Idiopathic scoliosis diagnosis

A

. Diagnosis of exclusion
. Classified based on age patient was at time of diagnosis (infantile, juvenile, adolescent if over 10 y/o, adult over 18 y/o)

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2
Q

In function scoliosis, spinal curvature ____ in response to side bending

A

Straightens

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3
Q

Causes of structural scoliosis

A 
. Congenital 
. Infectious diseases
. Trauma 
. Neurologic or muscular disorders 
. Tumors 
. Leg length inequality 
. Metabolic (rickets, osteoporosis, RA)
. Plagiocephaly (sleeping posture/cranial somatic dysfunction)
. Pain
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4
Q

Congenital/genetic effects of scoliosis

A 
. Hereditary 
. Vertebral anomalies
. Marfan’s (dec. GAG and collagen in discs)
. Turner’s 
. Aicardi syndrome 
. Friedreich ataxia 
. Schonberg disease
. RA
. Cushing 
. Osteogenesis imperfecta
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5
Q

Infectious diseases causing scoliosis

A

. Polio
. TB
. Osteomyelitis

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6
Q

Neurologic or muscular disorders causing scoliosis

A 
. Cerebral palsy
. TBI
. Polio
. Myelomeningocele
. Spinal muscle dystrophy 
. Spinal cord injury/tumor
. Spina bifida
. Tethered cord syndrome
. Arnold Chiari syrinx
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7
Q

Risk factors for scoliosis

A 
. RA 
. Muscular dystrophy 
. Polio
. Cerebral palsy
. Organ transplants 
. Female
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8
Q

Prevalence of adolescent idiopathic scoliosis btw 8-14 y/o

A

1-3%

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9
Q

Prevalence of adult idiopathic scoliosis 25 and above, and then ages 60-90

A

. 8% over 25 y/o

. 60% in 60-90 y/o

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10
Q

What is progression of scoliosis?

A

. Inc. in magnitude of Cobb angle over 5 degrees btw successive films
. Average is 2.3 degrees per year

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11
Q

T/F infantile scoliosis can spontaneously resolve, juvenile is progressive, and adult is persistent or worsens

A

T

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12
Q

Who has the greatest risk of scoliosis progression

A

. Girls with large curves prior to onset of menstruation

. Curvature happens equally in boys, but progresses more in females

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13
Q

Percentage of idiopathic curves diagnosed in infancy resolves?

A

50-90%

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14
Q

Do adults or children have a lot of variation in their spinal curve angle day to day?

A

Children change btw 10-20 degrees

. Adults have little variation

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15
Q

Causes of adult scoliosis

A

. Progression of childhood scoliosis

. Degenerative lumbar scoliosis: in patients over 50 due to disc degeneration

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16
Q

Untreated idiopathic scoliosis inc. mortality by wha tpercentage?

A

10%

17
Q

Percentage of idiopathic scoliosis untreated patients that have cardiopulmonary complications

A

14%

18
Q

T/F painful scoliosis is not idiopathic

A

T

19
Q

T/F pain is correlated w/ degree of curvature

A

F

20
Q

Pulmonary function with scoliosis

A

. Related to magnitude of Cobb angle
. Higher up the curvature occurs, the more likely problems w/ breathing occur
. Cob. Angle over 100 degree, vital capacity reduced to less than 50% of normal
. 25-50 degree spinal curvature, vital capacity dec. to 70% of normal
. Hypoxemia during sleep
. Pulmonary hypertension
. R ventricular strain measured by EKG causing enlargement
. Rapid/shallow breathing

21
Q

Hallmark of idiopathic scoliosis diagnosis

A

Absence of pain

22
Q

Cobb angle

A 
. Measured on x-ray 
. Ruler across top/bottom edges of involved vertebrae and lines drawn 
. Curves named for convexity 
. Rotoscoliosis is R convexity 
. Levoscoliosis is L convexity 
. Measures lat. or AP curves
23
Q

Normal angles of kyphosis and lordosis

A

. K: 20-50 degrees

. L: 25-60 degrees

24
Q

Limitations of Cobb Method

A

. Reliability and reproducibility

. Can’t accurately measure rotational motion

25
Q

Adam’s forward bending test is what percent sensitive for curves less than 10 and what percent for curves over 20 degrees?

A

. Less than 10: 70%

. Over 20: 90%

26
Q

Adam’s forward bending tests misses ___ percentage of scoliosis curves

A

. 15%

. Misses all lumbar curves

27
Q

Angle of trunk rotation (ATR)

A

. Rib hump during forward bending test
. Signifies vertebral rotation not humping
. Related to Cob angle
. Spinal curvature of 20 degree has ATR of 5 degrees
. Measured using scoliometer

28
Q

US preventative services task force scoliosis recommendation

A

. Routine screening for adolescent scoliosis not recommended

29
Q

T/F DOs should screen all initial patients for scoliosis no matter the age

A

T

30
Q

Children should be sent to orthopedics if curve is over ___

A

. 30 degrees

31
Q

Children with curves btw 20-30 degrees should be screened ___

A

Every 6 months

32
Q

T/F thoracic curves more likely to progress than thoracolumbar curves

A

T

33
Q

Patients with curve of 25 degrees or more who have progressed by ____ while being monitored may require treatment?

A

10 degrees

34
Q

Mid thoracic general curves classification

A

. 90% convex R
. 6 vertebra
. Apex T8-9

35
Q

Lower thoracic/thoracolumbar general curve classification

A

. Convex R
. 6-8 vertebra
. Apex T11-12

36
Q

Lumbar spine general classification of curve

A

. 70% convex R
. 5 vertebra
. Apex L1-2

37
Q

Double major curves general classification

A

. 90% convex right thoracic, convex left lumbar
. 5 thoracic, 5 lumbar
. Thoracic apex T7, lumbar apex L2

38
Q

Scoliosis angle degree classification

A

. Mild: 10-24 degrees
. Moderate: 25-50 degree
. Severe: over 50 degrees

OMM Lecture (16 decks)

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