scoliosis

Definitions

Scoliosis

· lateral curvature of the spine

· coronal plane deformity greater than 10^o (Cobb method)

Structural

· structural abnormality with rotation at apex

Nonstructural

· no structural abnormality or vertebral rotation

· CHIPS

Sciatic

· irritation of nerve root

· herniated disc

· tumour

· secondary paravertebral muscle spasm

Irritative

· painful condition of spinal column

· fracture

· tumour

Postural

· childhood

· slight correctable curve

· disappears on recumbency

Compensatory

· to compensate for

· leg length discrepancy

· hip flexion contracture

Hysterical

· teenage females

· no rotation or wedging on x-ray

Idiopathic

· commences before skeletal maturity

· diagnosis of exclusion

· no features to categorise it as

· congenital

· neuromuscular

· not due to

· tumour

· infection

· trauma

· not syndrome-related

classification

Spinal Research Society

Idiopathic (75%)

Infantile

· before age 3

Juvenile

· age 3 to onset of puberty (age 10)

Adolescent

· onset of puberty (age 10) and cessation of growth (age 16)

Neuromuscular (10%)

Neuropathic

· upper motor neurone disease

· eg. cerebral palsy

· lower motor neurone disease

· eg. poliomyelitis, spinal muscular atrophy

· other

· eg. syringomyelia

Myopathic

· eg. muscular dystrophy

Congenital (10%)

Failure of formation

· wedge vertebra

· hemivertebra

Failure of segmentation

· unsegmented bar

· block vertebra

Mixed

· complex

Other (5%)

Neurofibromatosis

Collagen diseases

· Marfans

· Ehlers Danlos

· osteogenesis imperfecta

Dysplasias

· diastrophic dwarfism

· spondyloepiphseal dysplasias

· mucopolysaccharidoses

Miscellaneous

Congenital

· spondylolisthesis (olisthenic)

Traumatic

· fractures

Infective

· vertebral osteomyelitis

Inflammatory

· RA

Metabolic

· rickets

Tumour

· spinal column