Structural Scoliosis Flashcards
(29 cards)
Which conditions mimic idiopathic scoliosis?
NF and syringomyelia
What are common causes of structural scoliosis?
Neurologic
Congenital
Connective tissue diseases
Idiopathic
What are reversible neurologic causes of structural scoliosis?
Chiari malformations
NF
Tethered spinal cord
What are irreversible neurologic causes of structural scoliosis?
Cerebral palsy
Muscular dystrophy
What are Chiari malformations?
Congenital deformities of the brain stem and upper spinal cord e.g. syringomyelia
How would you correct scoliosis induced by Chiari malformations?
Surgical decompression of the malformation
What imaging must be performed for all new structural scoliosis patients?
Craniocervical junction MRI
What is NF?
Benign tumors which may impinge on the spinal cord or nerve roots. Removal of these tumors results in correction of the scoliosis.
What is the treatment of choice for scoliosis caused by irreversible neurologic factors?
Surgical fusion of the spine
Which connective tissue diseases can cause structural scoliosis?
Marfan syndrome
Ehlers-Danlos syndrome
What is the most likely origin of idiopathic scoliosis?
Genetic in origin – it has a polygenic expression. First degree relatives have a 10% prevalence of scoliosis.
How do you distinguish between a double major curve and a simple C-shaped curve with a compensatory curve?
The compensatory curve will reverse with sidebending. The primary curve will not.
How can OMT treat scoliosis?
Removes coexisting somatic dysfunction
May halt the progression of mild curves
Helps maintain mobility of spine and rib cage
Improves respiratory and cardiac function in patients with severe curves
How does exercise prevent progression of scoliosis?
It doesn’t. There is no evidence that exercise changes the course of idiopathic scoliosis. It does aid in maintaining mobility of the spine. The better the mobility, the better the outcome of bracing or surgery.
How do braces aid in treatment of scoliosis?
Braces do not correct scoliosis. They are successful at halting the progression of a significant number of curves.
What is the most common brace?
Milwaukee brace
How do you determine the end of bone growth?
Risser scale
Judges end of bone growth by the fusion of the iliac crest with the ilium.
At what age does skeletal maturity occur?
16 in females
18 in males
Which treatment can avoid flat back syndrome?
Pedicle screws and contoured rod. Allows for preservation of sagittal plane curves.
What are the three types of scoliotic curves?
Idiopathic
Congenital
Paralytic
How do you determine the severity of the curve?
Cobb angle
Level of apex
Degree of rotation
Curves greater than ___ degrees are at increased risk for shortness of breath.
50
What is Wolff’s law?
Distortion of the pelvis caused by a structural scoliosis.
Bone is laid down along lines of stress.
When is surgery recommended for thoracic curves?
55 degrees
