Scoliosis

This is a curvature of the spine of greater than 10 percent in the coronal (side-to-side) plance. There are many different casues. Idiophathic scoliosis is the most common cause and occurs during the adolescent growth spurt. It is more common is females and is painless. If the curve is less than 25%, observation is indicated. If the curveture is 25-40%, bracing should be considered and surgery is usually indicated for curves greater than 40-50%.

Congenital scoliosis usually results from abnormal vertebrae and the progression usually does not improve with bracing. Many are associated with renal, cardiac, or other anomalies wich should be looked for. Paralytic scoliosis results from neuromuscular disorders. If there is scoliosis with progression, it is usual to follow with X-rays every 6 months. The main reason to perform surgery is stop the progression of the curvature. Usually, posterior spinal fusion will be sufficient in idiopathic scoliosis. Neuromuscular disorders associated with scoliosis mar require anterior as well as posterior fusion. Metal rods, with hooks or wires, may supplement the fusion.