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Scoliosis, Pediatric

Brian P. Hasley, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Coronal plane deformity (lateral curvature) of spine exceeding 10 degrees on radiographs with associated rotational deformity of the spine 

EPIDEMIOLOGY

Adolescent idiopathic scoliosis...

DIAGNOSIS

  • Idiopathic scoliosis is a diagnosis of exclusion.

  • Screening

    • Scoliosis screening recommended for children between 10 and 14 years

    • Many states have school screening programs.

    • Adams forward bend te...

TREATMENT

GENERAL MEASURES

Principles of management are based on severity of deformity and on likelihood of progression. 
  • Observation

    • Curves <25 degrees

      • Immature patients (Risser 0, 1, 2) should be ree...

ONGOING CARE

PROGNOSIS

  • Overall good for most patients

  • Risk of curve progression related to patient’s maturity (Risser sign, menarcheal status) and to size of curve

  • Curves <20 to 25 degrees have low ri...

ADDITIONAL READING

  • Dormans JP. Establishing a standard of care for neuromonitoring during spinal deformity surgery. Spine (Phila Pa 1976).  2010;35(25):2180–2185. [View Abstract on OvidInsights]

  • D...

CODES

ICD9

  • 737.30 Scoliosis [and kyphoscoliosis], idiopathic

  • 737.10 Kyphosis (acquired) (postural)

  • 737.20 Lordosis (acquired) (postural)

  • 737.32 Progressive infantile idiopathic scoliosis

  • 737.31 Resolving i...

FAQ

  • Q: How long do you observe a patient with spinal asymmetry before ordering a radiograph?

  • A: It depends on the presence or absence of abnormalities on the physical exam. If any of the signs mentione...

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