Scoliosis In Peds

Question 1

What is scoliosis characterized as

Answer 1

Lateral curvature of the spine >10 degrees
*rotation occurs as well
*thoracic, lumbar or both

Question 2

Which gender is more likely to have scoliosis

Answer 2

Girls 7x more likely

Question 3

Does pain usually happen in scoliosis (peds)

Answer 3

No its uncommon

Question 4

What will be found on the PE

Answer 4

1. Uneven pelvic height, pelvic asymmetry
   *inaccurate
2. Forward flexion (most sensitive)
3. L-sided curvatures
4. Cavus feet

Question 5

What tests to order

Answer 5

1. Radiographs
   *AP and lateral (full length X-rays)
2. Cobb angle
   *measure intersecting angle of the perpendiculars
   *upper curve and lower curve

Question 6

What are the adverse of scoliosis

Answer 6

1. Restrictive pulmonary disorders
   *spine is so curved lungs cannot extend
2. Progression of curvature
   *<50 degrees at skeletal maturity will stop
   *>60 progression will continue

Question 7

Is back pain with scoliosis common in adults

Answer 7

Yes

Question 8

What is the treatment

Answer 8

1. Observation
2. Exercise (no benefit)
3. Brace
   *in 20 to 45 degrees

Question 9

What are the surgical options

Answer 9

1. Spinal fusion
   *for idiopathic curves >50 degrees

Question 10

What are the adverse outcomes of treatment

Answer 10

1. Curve may progress despite brace treatment

Question 11

When to refer

Answer 11

1. Convex L thoracic curve
2. Pain
3. Abnl neuro findings
4. Bowel/bladder dysfunction
5. Deformities of feet