Hbd1: Scoliosis, Desai

Front 1

most common curve in scoliosis

Back 1

right thoracic curve

(next most common is a double thoracolumbar curve)

Front 2

most common etiology of scoliosis

sex-linked or autosomal dominant w/ variable expressivity and incomplete penetrance

Back 2

idiopathic (80%)

Front 3

complete unilateral congenital failure of formation

Back 3

hemivertebrae

Front 4

partial unilateral congenital failure of formation

Back 4

wedge vertebrae

Front 5

neuromuscular causes of scoliosis

Back 5

cerebral palsy
polio
muscular dystrophy
myelomeningocele
spinal muscular atrophy
Friedreich's ataxia

Front 6

presentation of idiopathic scoliosis

Back 6

typically found during routine school exam

parents may notice that clothes do not hang correctly

pain is usually NOT a symptom (search for the cause)

Front 7

exam for scoliosis that must be done in order to prevent a misdiagnosis

Back 7

osteopathic structural examination

Front 8

quantitative measurements of the degree of scoliosis on X-rays

Back 8

Cobb angles

Front 9

indications for referral to orthopedics

Back 9

10-20 degree scoliosis, PCP can follow up

greater than 20 degrees, ortho will treat and follow up

Front 10

goal of treatment of scoliosis

Back 10

prevent progression to 50 degrees at time of skeletal maturity (these curves tend to continue progressing)

Front 11

indications for bracing

How long is the brace worn

Back 11

usually for progressive curves of 20-45 degrees (don't need to brace those that don't progress)

Brace is worn for >16hr/day x 3-4yrs until skeltally mature

Front 12

brace for mild to moderate scoliosis

Back 12

Milwaukee brace (only remove for bathing and skin care)

Front 13

brace used for curves with an apex below T10

Back 13

TLSO orthotic (Boston brace)

Front 14

brace involved in nighttime only program (better for adolescents)

Back 14

Charleston bending brace

Front 15

indication for surgical treatment

Back 15

curves greater than 50% or greater than 40% that are likely to progress

Front 16

use of electrical stimulation in treatment of scoliosis

Back 16

stimulate contralateral muscles, not much success

Front 17

characteristics of infantile scoliosis (0-3 years old)

Back 17

males > females

convexity to left (*unique)

85% resolve spontaneously

Front 18

characteristics of juvenile scoliosis (4 to puberty)

Back 18

curves appear around ages 6 to 9

most progress steadily

Front 19

characteristics of adolescent scoliosis (puberty to adulthood)

Back 19

most common presentation (80%)

females more likely to go to surgery (8:1) due to progression

deformity increases w/ growth spurt

Front 20

treatment for congenital scoliosis

Back 20

surgery (try to wait until older)
It will stop growth but patient is usually vertically challanged

Front 21

two types of congenital failure of segmentation (bonding of 2 or more vertebrae)

Back 21

Unilateral unsegmented bar

Bilateral unsegmented (block vertebrae)

Front 22

rising in the rib cage and/or swelling of the paravertebral musculature on one side

Back 22

Positive forward bending test

Front 23

what is essential in the Dx and Tx of scoliosis?

Back 23

X-rays and Cobb angle

Front 24

General principles for the managment of idiopathic scoliosis

Back 24

OMT

Observe and follow patient...may need referral to ortho