Scoliosis & Kyphosis (Spinal Deformities)
Scoliosis is a lateral curvature of the spine with rotation. Kyphosis is an excessive posterior curvature of the thoracic spine. Early detection is key to preventing progression.
1. Scoliosis
- Adolescent Idiopathic Scoliosis (AIS): Most common type (Females > Males for severe curves).
- Screening: Adam's Forward Bend Test reveals a "Rib Hump" due to vertebral rotation.
- Measurement: Cobb Angle on X-ray.
2. Management of Scoliosis
- < 25 degrees: Observation (X-ray every 6 months).
- 25 - 45 degrees: Bracing (Boston Brace / Milwaukee Brace) to stop progression.
- > 45-50 degrees: Surgery (Spinal Fusion with instrumentation).
3. Kyphosis
- Postural: Flexible, correctable.
- Scheuermann's Disease: Rigid structural kyphosis in adolescents. Wedging of >5 degrees in 3 consecutive vertebrae. Schmorl's nodes present.
25 Practice MCQs
Q1. Scoliosis is defined as a lateral curvature of the spine greater than:
Answer: A). Below 10 is spinal asymmetry.
Q2. Adam's Forward Bend Test detects:
Answer: A). Rotation pushes ribs posteriorly on the convex side.
Q3. The Risser Sign measures:
Answer: A). Risser 0-5. Lower Risser = Higher risk of progression.
Q4. Scheuermann's Kyphosis is characterized by:
Answer: A). Structural kyphosis, not postural.
Q5. Surgery is generally indicated for scoliosis curves greater than:
Answer: A). Due to risk of progression into adulthood and pulmonary compromise.
Q6. The most common pattern of Idiopathic Scoliosis is:
Answer: A). Left thoracic curves are red flags for other pathology (e.g., tumor/syrinx).
Q7. The Boston Brace is a:
Answer: A). Standard for apex below T7.
Q8. Congenital Scoliosis is caused by:
Answer: A). Often progresses rapidly.
Q9. Does bracing correct the curve permanently?
Answer: B). Success = curve does not get worse.
Q10. Schroth Method is:
Answer: A). Focuses on derotation and breathing.
Q11. Neurofibromatosis can cause:
Answer: A). "Pencil-pointing" of ribs is a sign.
Q12. The Milwaukee Brace (CTLSO) is used for:
Answer: A). Has a neck ring.
Q13. Functional Scoliosis disappears when:
Answer: A). e.g., caused by leg length discrepancy.
Q14. Cobb angle is measured by drawing lines along:
Answer: A). The intersection angle is the Cobb angle.
Q15. Pulmonary function is typically compromised if the thoracic curve exceeds:
Answer: A). Cor Pulmonale can occur in very severe cases (>90).
Q16. Growing Rods are used for:
Answer: A). Fusing a child's spine too early stops thorax growth (Thoracic Insufficiency Syndrome).
Q17. In a Right Thoracic curve, the spinous processes rotate:
Answer: A). The vertebral body rotates to the convexity, pushing the ribs back (hump).
Q18. Neuromuscular Scoliosis (e.g., Cerebral Palsy) usually presents with:
Answer: A). "Collapsing spine". Often requires fusion to the pelvis.
Q19. Schmorl's Nodes are typically seen in:
Answer: A). Herniation of disc material into the endplate.
Q20. Normal Thoracic Kyphosis is:
Answer: A). Anything >45 is hyperkyphosis.
Q21. Which factor indicates a HIGH risk of curve progression?
Answer: A). Peak growth velocity is the danger zone.
Q22. Senile Kyphosis (Dowager's Hump) is due to:
Answer: A). Anterior wedging of multiple vertebrae.
Q23. The Nash-Moe method measures:
Answer: A). Based on where the pedicle is relative to the midline.
Q24. Post-spinal fusion, which motion is lost permanently?
Answer: A). Fusing T3-L4 leaves some lumbar motion (L4-S1).
Q25. Klapp's Crawling exercises were historically used for:
Answer: A). Mobilization of the spine in quadruped.
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