Scoliosis Questions

1. Which of these is not an effective treatment for scoliosis?

a. Physical therapy
b. Electrical muscle stimulation
c. Milwaukee brace
d. Anterior fusion of lumbar spine

Electrical muscle stimulation is not a suggested treatment for scoliosis. Mild to moderate curvature may be treated with physical therapy, if the angle is 35 degrees a Milwaukee brace should be worn, if curvature is greater than 45 degrees surgical intervention such as the anterior fusion of the lumbar spine may be performed.

2. Which of these is not a potential cause for scoliosis?

a. Idiopathic
b. Congenital
c. Neurofibromatosis
d. Systemic lupus erythematous

There are many causes of scoliosis to include congenital, secondary to traumatic injury, spinal tuberculosis, infantile poliomyelitis and others but the most common is idiopathic. Scoliosis can also present as a component to other genetic disorders such as neurofibromatosis.

3. Mrs. Burns is a 24 year old newly married patient here for her first clinic appointment today. She informs you that she has a history of scoliosis that was corrected by spinal surgery with rodding years ago but is now considering starting a family. Which of these statements would be the correct information for this patient?

a. Because you know that this type of surgery is done for curvatures greater than 30 degrees you reply “ This surgical correction increases the risk of miscarriage, it may be necessary to discuss alternative options”
b. You are aware that this surgery increases her likelihood of infertility so you reply “ It might to be best to begin with infertility testing as well as discuss alternative family planning options”
c. “Research has shown that women who have received treatment via brace or surgery for scoliosis tend to experience normal pregnancy and deliveries with proper management, we can begin with preconception counseling”
d. “The stress of pregnancy and delivery causes progression of the spinal curvature which will require further surgical correction after delivery”

At present, research reflects that normal pregnancy and delivery is obtainable through proper management. Scoliosis treatment via surgery or brace does not predispose to miscarriage or been linked to infertility at present. Although there may be a slight progression of curvature in pregnancy, it is not significant enough to require further surgical intervention.

4. Which of these statements is correct involving the administration of epidural anesthesia of a parturient with scoliosis that has undergone surgical correction?

a. Having rods in place does not increase the risk of complications while providing adequate pain control
b. Having rods in place moderately increases the risk of delivery complications while providing adequate pain control
c. Having rods in place severely increases the risk of delivery complications, it is necessary to weigh the risks against the benefit
d. Having rods in place does not increase the risk of complications but may not provide adequate pain control

Research suggests that having rods in place does not increase the risk of delivery complications and epidural anesthesia can provide safe and adequate pain control

5. Which contraception method would be contraindicated for a female patient with severe scoliosis?

a. Abstinence
b. Combined oral contraceptive
c. Rhythm method
d. Female barrier protectors

The use of combined oral contraceptives is useful for young women with mild to moderate scoliosis without mobility issues, patients with severe disorder are at an increased risk of thromboembolisms. All of the other above listed methods are acceptable choices for severe scoliosis