FREE ACCESS · 7 PAGES

Scoliosis

Scoliosis is a three-dimensional deformity of the spine characterized by a lateral curvature with vertebral rotation, typically defined radiographically by a Cobb angle greater than 10°. It may be idiopathic, congenital, neuromuscular, or secondary to other conditions. Management depends on the patient’s age, skeletal maturity, curve magnitude, progression, and underlying cause, ranging from observation and bracing to surgical correction.

Scoliosis is a complex three-dimensional spinal deformity in which there is lateral curvature of the spine associated with vertebral rotation and alteration of the normal sagittal profile. A structural curve is generally diagnosed when the Cobb angle measures more than 10° on a standing spinal radiograph. Scoliosis may be classified as idiopathic, congenital, neuromuscular, or secondary to other disorders. Adolescent idiopathic scoliosis is the most common form and typically occurs in otherwise healthy children around the pubertal growth spurt. Patients may present with uneven shoulders, scapular prominence, waist asymmetry, pelvic tilt, or a rib hump, which becomes more evident on the Adam forward bend test. Evaluation includes a detailed history and neurological examination, assessment of limb length and skeletal maturity, and standing posteroanterior and lateral whole-spine radiographs. The Cobb angle is used to quantify curve magnitude, while skeletal maturity can be estimated using systems such as the Risser sign. MRI may be indicated in atypical curves, neurological abnormalities, severe pain, or suspicion of an underlying intraspinal pathology. Treatment is determined by the magnitude of the curve, risk of progression, skeletal maturity, symptoms, and underlying diagnosis. Mild curves may be managed with observation and periodic radiographic follow-up. Bracing is used in selected growing children with moderate progressive curves to reduce the risk of further progression. Larger or significantly progressive deformities may require surgical correction and spinal fusion, commonly using posterior instrumentation. The main goals of treatment are to prevent progression, maintain spinal balance, preserve pulmonary function, achieve acceptable cosmetic alignment, and minimize long-term disability.

Free to read with your Orthonotes account. Save your place and annotate as you learn.