OPP-2 Week 5

Question 1

What is the definition of Scoliosis Deformity?

Answer 1

Lateral curvature of the spine usually accompanied by rotation; major deformity is rotation, resulting in a posterior rib hump.

Question 2

How is the scoliosis curve described?

Answer 2

Described by the side of the convexity (e.g., Convex RIGHT).

Question 3

What is a key feature of Non-Structural (Functional) Scoliosis?

Answer 3

Curve is flexible; corrects on sidebending toward convexity; severe vertebral rotation is not characteristic; may result from leg-length discrepancy.

Question 4

What characterizes Structural Scoliosis?

Answer 4

Curve is rigid (‘curves persist’); cannot be voluntarily straightened; loss of flexibility is the first sign.

Question 5

Which muscles and ligaments shorten in Structural Scoliosis on the concave side?

Answer 5

• Interspinalis
• Erector spinae
• Quadratus lumborum
• Psoas major/minor
• Obliques
• Abdominals
• Associated ligaments (ALL, PLL, ligamentum flavum, interspinous)

Question 6

What does the progression of Structural Scoliosis in skeletal immaturity follow?

Answer 6

Follows the Hueter-Volkmann Law (a corollary of Wolf’s Law).

Question 7

What is the application of the Hueter-Volkmann Law?

Answer 7

Increased compression on the vertebral growth plate impairs growth (Concave side); Less compression accelerates growth (Convex side); leads to progressive vertebral wedging.

Question 8

What is the age range and most common curve type for Infantile Idiopathic Scoliosis?

Answer 8

Occurs birth to 3 years; Most common curve is Left-sided thoracic convexity; most resolve spontaneously.

Question 9

What is the age range and most common curve type for Juvenile Idiopathic Scoliosis?

Answer 9

Occurs ages 3-10; Most common curve is convex right thoracic; more common in girls.

Question 10

What is the prevalence and curve type for Adolescent Idiopathic Scoliosis (AIS)?

Answer 10

Most common type (80–85% of idiopathic cases); Onset >10 years; >90% are convex right thoracic curves.

Question 11

At what stage is the rate of spinal curve development most rapid in AIS?

Answer 11

At the beginning of puberty, approximately Tanner Stage 2.

Question 12

When does menarche occur relative to AIS progression?

Answer 12

Menarche occurs after approximately two-thirds (2/3) of the pubertal growth spurt period; progression decreases once peak growth has passed.

Question 13

What are risk factors for continued AIS progression?

Answer 13

Younger age at development correlates with less favorable prognosis; longer time required to reach skeletal maturity (e.g., active adolescent girls with delayed menses).

Question 14

What spinal cord abnormalities are found in AIS?

Answer 14

Found in 20% of AIS subjects (e.g., tumor, syringomyelia, or tethered cord).

Question 15

What clinical correlation is found in vestibular deficit in idiopathic scoliosis?

Answer 15

Found in two-thirds (67%) of idiopathic scoliosis children, but NOT in patients with congenital scoliosis.

Question 16

What molecular factors are involved in progressive idiopathic scoliosis?

Answer 16

Marked increase in Calmodulin (calcium-binding receptor protein) and a decreased level of Melatonin (produced in Pineal gland; acts as Calmodulin antagonist).

Question 17

What is the etiology of Congenital Scoliosis?

Answer 17

Results from defects in embryologic development of vertebrae (e.g., Failure of formation like hemi-vertebra, or Failure of segmentation like unilateral bar or bilateral bloc).

Question 18

What are the associated comorbidities in Congenital Scoliosis?

Answer 18

• Genitourinary defects (20–40%)
• Cardiac abnormalities (10–15%)
• Intraspinal anomalies (10–15%)
• VATER/VACTERL association

Question 19

What condition is associated with high-incidence neuromuscular scoliosis (myopathic)?

Answer 19

Duchenne’s muscular dystrophy (85–90% of male patients develop scoliosis).

Question 20

What condition is associated with high-incidence neuromuscular scoliosis (neuropathic, LMN)?

Answer 20

Poliomyelitis/dysautonomia (86% develop scoliosis).