General concepts 1 Why do patients with neuromuscular disorders develop spinal deformities? Neuromuscular spinal deformities develop in patients with underlying neuropathic or myopathic disorders due to trunk muscle weakness, spasticity, or spinal imbalance, which compromise the ability to maintain normal…
1 Define congenital scoliosis. A lateral curvature of the spine caused by vertebral anomalies that produce a frontal plane growth asymmetry. The anomalies are present at birth, but the curvature may take years to become clinically evident. 2 What genes…
1 What is idiopathic scoliosis? Idiopathic scoliosis is the most common type of scoliosis. At present it is uncertain whether this deformity represents a single disease entity or reflects a similar clinical expression of several different disease states. Idiopathic scoliosis…
Background 1 Why is the age of onset of scoliosis important? Growth and development of the spinal column, thorax, and lungs are interdependent. Deformities affecting the spine and thorax in the first decade of life adversely impact lung development and…
Development of the cervical spine 1 What family of genes regulates development of the vertebral column? The Hox (homeobox) and Pax (paired box) genes regulate embryonic differentiation and segmentation of the developing vertebral column. 2 Describe the development of the…
Evaluation 1 Discuss the epidemiology of back pain in children compared with adults. Traditionally, back pain in children was considered uncommon, and thought to be associated with a definable cause. Current data show that back pain is a frequent complaint…
1 What is neuromodulation? Neuromodulation involves the use of both implantable and nonimplantable medical device technologies for treatment of disease through enhancement or suppression of the activity of the nervous system using electrical, pharmacologic, or other agents. Neuromodulation therapies may…
General considerations 1 Why is the term failed back surgery syndrome considered controversial? Failed back surgery syndrome is an imprecise term used to refer to patients with unsatisfactory outcomes after spine surgery due to persistent or recurrent pain in the…
1 Discuss some limitations associated with nonarthroplasty surgical treatment options for degenerative spinal conditions. Neural decompression procedures violate the structural integrity of the spine and may lead to segmental spinal instability unless fusion is performed. Spinal fusion procedures increase stress…
1 What is minimally invasive spine surgery? Minimally invasive spine (MIS) surgery is a surgical approach or technique intended to provide equivalent or superior outcomes compared with conventional open spine surgery as a result of limiting approach-related surgical morbidity. In…