Etiology: The following four forms of scoliosis are the most common.1. Idiopathic scoliosis (IS) is the most common of all forms of lateral deviation of the spine. By definition, it is a lateral curvature of the spine in an otherwise healthy child, for which a currently recognizable cause has not been found (idiopathic). Idiopathic scoliosis is broken down into four categories based on age:A. Infantile - children ages 3 and underB. Juvenile - 3-9 years oldC. Adolescent - 10-18 years old (AIS; most common form of scoliosis, representing approximately 80% of idiopathic scoliosis cases)D. Adult - after skeletal maturity.
2. Congenital scoliosis is the result of osseous malformations of the spine. The process of formation of the spine is extremely complex. The vertebral formation process result in either a failure of formation of part of a vertebra (hemivertebra), failure of segmentation of a vertebra (two vertebra stuck together on one side or a unilateral bar), or some combination of the two. The result is essentially a growth disturbance of the spine that produces a curvature. No two cases of congenital scolioisis are the same, and each pattern requires careful assessment to determine the risk that a serious curve will occur and need treatment.
3. Neuromuscular scoliosis refers to curvature of the spine associated with a neurological condition like cerebral palsy or spina bifida. There are many other forms of neuromuscular scoliosis as well. Each form has its own unique natural history and risks for causing greater problems.
4. A difference in the length of the legs is quite common. Most patients can tolerate up to 1/2" of difference with very few side effects. The problem with a limb length difference is that it will cause a small scoliosis. These curves rarely get worse unless the limb length difference gets worse.
Less common but better defined etiologies of the disorder include scoliosis in neurofibromatosis, and mesenchymal disorders like Marfan's syndrome.
Contents of this special supplement:Definition [p. 1-2]; Etiology [p. 2]; Epidemiology [p. 2]; Symptoms [p. 2-3]; History [p. 3-4]; Physical Evaluation [p. 4-5]; Classifications [p. 5]; Conservative Management Goals [p. 5-6]; Observation [p. 6]; Orthotics [p. 6-7]; Systematic application of conservative treatment with respect to Cobb’s angle and maturity (includes case examples] [p. 7-11]; Orthopedic Pearls [p. 11-13]; Conclusion [p. 13]; References (45) [p. 13-15]; Literature Review: Deformity [p. 15-18]; Diagnostics [p. 18-22]; Treatment [p. 22-24]
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