Spine: dystrophic scoliosis in neurofibromatosis: 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: dystrophic scoliosis in neurofibromatosis

Sample item

A 7-year-old with multiple cafe-au-lait spots has a short, sharply angulated thoracic curve with scalloped vertebral bodies and thin, pencil-like ribs. How is this curve best managed?

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

The answer and the reasoning

A. Early spinal fusion because dystrophic curves progress rapidly and braces fail

Dystrophic scoliosis in neurofibromatosis type 1 is a short, sharp curve with vertebral scalloping, rib penciling and a tendency to rapid progression and kyphosis. Braces do not control it, so early posterior fusion, sometimes with growing constructs, is usually needed. Nondystrophic curves behave like idiopathic scoliosis.

Option by option

  • A. Early spinal fusion because dystrophic curves progress rapidly and braces fail (correct)

    Correct. Rapidly progressive dystrophic curves need early fusion.

  • B. Bracing until skeletal maturity

    Bracing fails in dystrophic curves.

  • C. Physiotherapy alone

    Physiotherapy does not alter the curve.

  • D. Observation with yearly review

    Observation allows progression and cord risk.

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.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Early spinal fusion because dystrophic curves progress rapidly and braces fail. Dystrophic scoliosis in neurofibromatosis type 1 is a short, sharp curve with vertebral scalloping, rib penciling and a tendency to rapid progression and kyphosis.

Why is "Bracing until skeletal maturity" not the answer?

Bracing fails in dystrophic curves.

Why is "Physiotherapy alone" not the answer?

Physiotherapy does not alter the curve.

Why is "Observation with yearly review" not the answer?

Observation allows progression and cord risk.

What concept does this question test?

It tests Spine: dystrophic scoliosis in neurofibromatosis in Orthopaedics. Braces do not control it, so early posterior fusion, sometimes with growing constructs, is usually needed. Nondystrophic curves behave like idiopathic scoliosis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: dystrophic scoliosis in neurofibromatosis?

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.