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)

Understanding scoliosis risk in spinal cord lesions comes down to how well the trunk muscles are innervated. When a lesion is higher, trunks muscles—the core stabilizers of the spine—are more affected, leading to weaker postural support and a higher chance that the spine will curve as the child grows. In contrast, lower-level lesions spare more trunk innervation, giving better trunk stability and reducing the risk of developing scoliosis. Lesions at sacral levels mainly impact the legs, with trunk muscles largely preserved, so scoliosis risk remains lower. Mid-thoracic lesions provide some trunk innervation, so the risk sits between high lesions and sacral lesions.

Therefore, the pattern that best explains scoliosis risk is higher levels with less trunk innervation.