Learning objectives
To understand the key measurements in the diagnostic evaluation of scoliosis
To understand the classification and causes of scoliosis
To understand the basic principles of scoliosis management
Background
Scoliosis (Greek word skoliōsis meaning "crooked") is a deformity of the spine defined by lateral curvature of more than ten degrees and rotation of the vertebrae.
The causes of scoliosis vary but can be broadly classified into idiopathic,
congenital,
neuromuscular,
degenerative and pathological.
The natural history of this condition is related to aetiology and the age of presentation and this usually determines the treatment.
Initial evaluation of scoliosis includes a thorough patient history,
physical examination and standing coronal radiographs,
which are used conventionally to measure...
Imaging findings OR Procedure details
An understanding of the nomenclature and methods of measurement used to describe scoliosis is essential.
Identification of the curve apex and significant vertebrae is imperative in defining the type of curve,
selecting the surgical approach and determining the optimal level for fusion.
NOMENCLATURE [1,2]
The apex is the vertebra or disc with the greatest rotation or furthest deviation from the centre of the vertebral column.
It also has the least amount of tilt,
as measured by the angle of the endplates (top and bottom edges...
Conclusion
Understanding of the nomenclature and key measurements used describing scoliosis is essential in constructing accurate and informative reports.
Identification of primary and secondary curves is required for accurate classification and treatment planning.
The causes of scoliosis can be broadly classified into idopathic,
congenital,
neuromuscular and pathological.
Idiopathic scoliosis is diagnosed after underlying causes are excluded and is generally further classified according to patient age and disease characteristics as infantile (age 0–3 years),
juvenile (age 4–10 years),
or adolescent (age 11–18 years).
Adult-type idiopathic scoliosis is...
Personal Information
Dr.
A Desai
Consultant Musculoskeletal Radiologist
Guy's & St.
Thomas' NHS Trust
Dr.
S Saha
Specialist Registrar in Radiology
Guy's & St.
Thomas' NHS Trust
Mr.
G Nussbaum
Medical Student
Guy's,
King's & St.
Thomas' Hospitals Medical School
Dr.
R Houghton
Consultant Musculoskeletal Radiologist
Guy's & St.
Thomas' NHS Trust
References
1.
Malfair D,
Flemming AK,
Dvorak MF et al.
Radiographic evaluation of scoliosis: review.
AJR Am J Roentgenol 2010; 194 (Supp3): S8–S22.
2.
Kim H,
Kim HS,
Moon ES et al.
Scoliosis Imaging: What Radiologists Should Know.
Radiographics 2010; 30: 1823-1842.
3.
Robinson CM,
McMaster MJ:Juvenile idiopathic scoliosis: Curve patterns and prognosis in one hundred and nine patients.
J Bone Joint Surg Am 1996,
78A:1140-1148.
4.
Lenke LG,
Betz RR,
Harms J et al.
Adolescent idiopathic scoliosis: A new classification to determine extent of spinal...