Scoliosis

PREPARED BYDR. MAJID AL-HOMIEDAN

Chapman Explained

Chapman Explained Dr. Majid Al-Homiedan

Scoliosis




Infantile idiopathic scoliosis

diagnosed before the age of 4 years.

90% are thoracic and concave to the right.

More common in boys.

90% resolve spontaneously.



Juvenile idiopathic scoliosis

diagnosed between 4 and 10 years.

More common in girls.

Almost always progressive.



Adolescent idiopathic scoliosis

diagnosed between 10 years and maturity.

More common in females.

Majority are concave to the left in the thoracic region.



Failure of formation and Scoliosis

Incarcerated hemivertebra. A straight spine with little tendency to progression.

B. Free hemivertebra. May be progressive.

C. Wedge vertebra. Better prognosis than a free hemivertebra.

D. Multiple hemivertebrae. Failure of formation on the same side results in a severe curve.

. E. Central defect. Butterfly vertebra



Failure of Segmentation and Scoliosis

A. Bilateral block vertebra and a short spine, e.g. Klippel-Feil.

B. Unilateral unsegmented bar. Severely progressive curve with varying degrees of kyphosis or lordosis depending on the position of the bar



Mixed defects and Scoliosis

Unilateral unsegmented bar and a hemivertebra. Severely progressive.

Partially segmented incarcerated hemi vertebra.

Bilateral failure of segmentation Incorporating a hemi vertebra



Myelomeningocele and scoliosis

Linked to neurological impairment.

Growth potential.Other vertebral

anomalies.



Spinal Muscular Dystrophy and Scoliosis



Friedreich’s Ataxia and scoliosis

About 2/3 of patients with FA develop scoliosis mainly due to muscle weakness.

there’s speculation that frataxin gene deficiency might have direct effects on bone development.



Poliomyelitis and Scoliosis

Viral invasion of motor neurons leading to wallerian degeneration,muscle weakness and eventually scoliosis.

Leg length discrepancy and limping is also another cause of scoliosis.



Cerebral Palsy and Scoliosis

Whether flaccid or spastic cerebral palsy both cause scoliosis.



Muscular Dystrophies and Scoliosis

Duchenne muscular dystrophy, deficient gene that makes dystrophin. leading to muscle break-down and weakness.

Becker muscular dystrophy Myotonic dystrophy. Limb-girdle muscular

dystrophy Facioscapulohumeral

muscular dystrophy



Neurofibromatosis and Scoliosis

in up to 40% of patients short, sharply angulated

curve which involve only few vertebra associated with:

- Neural foramina enlargement

- Rib penciling- kyphosis- Vertebral body scalloping- Dural ectasia- Soft tissue masses



scoliosis in 40-60%. Double structural curves are typical.

Marfan’s syndrome and scoliosis



Homocystinuria and Scoliosis

Inherited disorder of the metabolism of the amino acid methionine.

Multisystemic disorder of the connective tissue, muscles, CNS, and cardiovascular system.



Scoliosis Post Radiotherapy

Wedged and hypoplastic vertebrae ± unilateral pelvic or rib hypoplasia



Leg-length discrepancy and Scoliosis

A flexible lumbar curve, convex to the side of the shorter leg

Disparity of iliac crest level.



Osteoid Osteoma and Scoliosis

10% occur in the spine.

A lamina or pedicle at the apex of the curve will be sclerotic or over grown.



Osteoblastoma and Scoliosis

The spine is involved in about 50 percent of cases and it usually arises in the posterior elements.

It typically causes dull pain and may be associated with scoliosis or nerve compression.




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Scoliosis