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Scoliosis (Aetiology (Idiopathic
Infantile (0-3y), juvenile (3-10y),
…
Scoliosis
Aetiology
Idiopathic
Infantile (0-3y), juvenile (3-10y),
adolescent (10-18y), adult (>18y)
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Congenital
Spine: spina bifida, congenital scoliosis
Neuromuscular: SMA, DMA, CMT, NF
CT disorder: Marfans
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Diagnosis
Examination
Spinal exam
Visible lateral curvature, palpable curvature,
Anterior flexion: visible curvature, uneven ribs
at the convex side (hump)
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Investigations
Imaging
Standing upringh spinal X-ray
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History
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FH
Scoliosis, neuromuscular disorders,
musculoskeletal diseases
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SH
Living arrangements, school/occupation,
smoking, alcohol, diet
PC/HPC
Pain (SOCRATES), deformity,
restricted movement, progression
Complications
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Psychological
Anxiety, depression
Low self esteem
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Management
Medical
Analgesia
Indication: pain
E.g. paracetamol, ibuprofen
Surgical
Spinal fusion and stabilisation
Indication: <7y to max spine/lung growth,
complications from progressive deformity
MOA: insertion of screws and rods;
use growing rods if final growth not reached;
may also need thoracotomy (rib removal)
Conservative
Information, advice support
Refer to orthopedics (measure Cob angle)
Bracing (halts progression in growing children; wear >20h/d)
Epidemiology
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Can occur any age, child or adult
Pathophysiology
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Mechanism
Lateral curvature (Cob angle) in thoracic or lumbar spine of >10 degrees, plus associated rotation of spinal column and muscle spasm
As patient grows, curvature increases (worse if earlier onset)
If over 45 degrees by end of bone growth, it will continue to progress post puberty (Tower of Pisa analogy)
Definition
Orthopedic disorder of abnormal spinal
development with lateral curvature (>10 degrees)
and secondary vertebral rotation