Which levels are more at risk of scoliosis?

Which levels are more at risk of scoliosis?

• A. Lower levels with full trunk innervation
• B. Higher levels with less trunk innervation
• C. Mid-thoracic levels with partial trunk innervation
• D. Sacral levels with minimal trunk innervation

Answer: (B)

The tendency to develop scoliosis in this context is driven by how much trunk muscle control is lost. When the spinal lesion is higher up, there is less trunk innervation and more paralysis of the paraspinal and abdominal muscles that normally help stabilize the spine. Without that muscular support, the spine is more prone to curvature and progressive scoliosis as the child grows. So, higher levels with reduced trunk innervation create the greatest risk.

In contrast, lower levels that still have decent trunk innervation maintain better trunk stability, and sacral levels spare much of the trunk muscles, both of which lower the risk of scoliosis. Mid-thoracic with partial trunk innervation would have some stability but not as much as lower levels, so the risk sits between these extremes.