Idiopathic Scoliosis

Question 1

Idiopathic Scoliosis

Answer 1

Lateral curvature with unknown cause

Most common form of scoliosis

Question 2

3 Factors that correlate with curve progression

Answer 2

Curve magnitude
Risser sign
Pt’s chronological age at time of dx

Question 3

Infantile Idiopathic Scoliosis

Answer 3

Children younger than age 3, manifests shortly after birth
<1% of all cases in US
M > F
Most are left curves
80-90% spontaneously resolve, rest result in severe deformity
May have environmental factors

Question 4

Juvenile Idiopathic Scoliosis

Answer 4

Develops btwn ages 3-9, usually recognized around 6 y/o
M/c R thoracic curve
M = F
High rate of progression, results in severe deformity if untreated
Curves > 30d, 100% need surgery
Curves 21-30, 75% need surgery

Question 5

Adolescent Idiopathic Scoliosis

Answer 5

Develops at/around time of puberty
80% of all cases
F > M, greater percentage of curves in F will progress
Many are structural at time of detection
Structural has greater chance of progressing throughout adolescence
Non-structural may remain flexible and be less problematic

Question 6

Cause of IS

Answer 6

Origin and mechanics still not understood

Cause is multifactorial (biomechanical, growth, genetic, etc)

Question 7

Progressive curve

Answer 7

A sustained increase of 5d or more on 2 consecutive examinations occurring at 4 and 6 month intervals

If left untreated can progress into adult life

Question 8

Factors that Influence Probability of Progression

Answer 8

1. Younger at dx = greater risk of progression
2. Double curve patterns have greater risk than single curve patterns
3. The lower the Risser Sign = greater the risk of progression
4. Curves w/great magnitude = greater risk of progression
5. Risk of progression in females is 10x greater than males with curves or comparable magnitude
6. Greater risk of progression present when curve develops before females get their period

Question 9

Outcomes

Answer 9

live functional and normal lives

Untreated = increased incidence of acute and chronic back pn

Cobb angle of 50d or greater at skeletal maturity = will have decreased pulmonary function

Thoracic curve– often report SOB

Surgical correction results in significant improvements in self-image, function, and level of activity

Complications of untreated scoliosis: severe deformity and disability, decreased pulmonary function, respiratory insufficiency, or right sided heart failure