Spine: neuromuscular scoliosis: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: neuromuscular scoliosis

Sample item

A 12-year-old wheelchair-using child with spastic quadriplegia has a long C-shaped curve of 70 degrees with pelvic obliquity, and is losing sitting balance. What is the usual operative approach?

ALong posterior spinal fusion extending to the pelvisBAnterior fusion of the apex onlyCBracing until maturityDObservation only

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Long posterior spinal fusion extending to the pelvis

Neuromuscular curves are long C-shaped curves that progress after skeletal maturity and cause pelvic obliquity and loss of sitting balance. Bracing does not stop progression. Posterior instrumented fusion from the upper thoracic spine to the pelvis restores balance and improves sitting.

Option by option

A. Long posterior spinal fusion extending to the pelvis (correct)
Correct. Fusion to the pelvis corrects obliquity and restores sitting balance.
B. Anterior fusion of the apex only
A short apical fusion leaves the pelvic obliquity uncorrected.
C. Bracing until maturity
Bracing does not control progression in neuromuscular scoliosis.
D. Observation only
Observation allows progression and worsening of function.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Long posterior spinal fusion extending to the pelvis. Neuromuscular curves are long C-shaped curves that progress after skeletal maturity and cause pelvic obliquity and loss of sitting balance.

Why is "Anterior fusion of the apex only" not the answer?

A short apical fusion leaves the pelvic obliquity uncorrected.

Why is "Bracing until maturity" not the answer?

Bracing does not control progression in neuromuscular scoliosis.

Why is "Observation only" not the answer?

Observation allows progression and worsening of function.

What concept does this question test?

It tests Spine: neuromuscular scoliosis in Orthopaedics. Bracing does not stop progression. Posterior instrumented fusion from the upper thoracic spine to the pelvis restores balance and improves sitting.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: neuromuscular scoliosis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.