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Idiopathic Scoliosis

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Chest Wall Deformities

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Abstract

Idiopathic scoliosis is the most common form of scoliosis seen in children. Other forms of scoliosis are of neuromuscular, syndrome related or congenital origin. Current evidence suggests that idiopathic scoliosis is a polygenic, multifactorial condition with a variable expression and severity of the deformity. As idiopathic scoliosis presents as a painless deformity in early childhood or mostly at onset of the pubertal growth spurt, school screening programs contribute to an early diagnosis. Conservative treatment consisting of corrective corsets and physiotherapeutic scoliosis specific exercises remain the mainstay of treatment in milder curves. Severe deformity with curves of more than 50° necessitate operative treatment. The demanding therapeutic challenge of this condition is to prevent progression of the curves during growth, as well as choosing the right time for surgical intervention. Clinical presentation, classification, conservative and surgical treatment options, decision making and the correlation with other chestwall deformities in idiopathic scoliosis are discussed to provide a state of the art diagnostic and treatment tool.

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References

  1. Vasiliadis ES, Grivas TB, Kaspiris A. Historical overview of spinal deformities in ancient Greece. Scoliosis. 2009;4:6-7161-4-6.

    Google Scholar 

  2. Andry N. Orthopaedia : or, the art of correcting and preventing deformities in children: by such means, as may easily be put in practice by parents themselves, and all such as are employed in educating children. To which is added, a defence of the orthopaedia, by Way of Supplement/by the Author, London, 1743.

    Google Scholar 

  3. Lonstein JE. Scoliosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res. 2006;443:248–59.

    Article  PubMed  Google Scholar 

  4. Weinstein SL, Zavala DC, Ponseti IV. Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am. 1981;63:702–12.

    Article  CAS  PubMed  Google Scholar 

  5. Burwell RG, Dangerfield PH, Moulton A, et al. Whither the etiopathogenesis (and scoliogeny) of adolescent idiopathic scoliosis? Incorporating presentations on scoliogeny at the 2012 IRSSD and SRS meetings. Scoliosis. 2013;8:4.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Wynne-Davies R. Familial (idiopathic) scoliosis. A family survey. J Bone Joint Surg Br. 1968;50:24–30.

    CAS  PubMed  Google Scholar 

  7. Cowell HR, Hall JN, MacEwen GD. Genetic aspects of idiopathic scoliosis. A Nicholas Andry Award essay, 1970. Clin Orthop Relat Res. 1972;86:121–31.

    Article  CAS  PubMed  Google Scholar 

  8. Riseborough EJ, Wynne-Davies R. A genetic survey of idiopathic scoliosis in Boston, Massachusetts. J Bone Joint Surg Am. 1973;55:974–82.

    Article  CAS  PubMed  Google Scholar 

  9. Blank RD, Raggio CL, Giampietro PF, Camacho NP. A genomic approach to scoliosis pathogenesis. Lupus. 1999;8:356–60.

    Article  CAS  PubMed  Google Scholar 

  10. Giampietro PF, Raggio CL, Blank RD. Synteny-defined candidate genes for congenital and idiopathic scoliosis. Am J Med Genet. 1999;83:164–77.

    Article  CAS  PubMed  Google Scholar 

  11. Ogilvie JW, Braun J, Argyle V, et al. The search for idiopathic scoliosis genes. Spine (Phila Pa 1976). 2006;31:679–81.

    Article  Google Scholar 

  12. Ward K, Ogilvie J, Argyle V, et al. Polygenic inheritance of adolescent idiopathic scoliosis: a study of extended families in Utah. Am J Med Genet A. 2010;152A:1178–88.

    Article  PubMed  Google Scholar 

  13. Montgomery F, Willner S. The natural history of idiopathic scoliosis. Incidence of treatment in 15 cohorts of children born between 1963 and 1977. Spine (Phila Pa 1976). 1997;22:772–4.

    Article  CAS  Google Scholar 

  14. McMaster MJ. Infantile idiopathic scoliosis: can it be prevented? J Bone Joint Surg Br. 1983;65:612–7.

    CAS  PubMed  Google Scholar 

  15. Dobbs MB, Lenke LG, Szymanski DA, et al. Prevalence of neural axis abnormalities in patients with infantile idiopathic scoliosis. J Bone Joint Surg Am. 2002;84-A:2230–4.

    Article  PubMed  Google Scholar 

  16. Goldstein LA, Waugh TR. Classification and terminology of scoliosis. Clin Orthop Relat Res. 1973;93:10–22.

    Article  Google Scholar 

  17. Davies G, Reid L. Effect of scoliosis on growth of alveoli and pulmonary arteries and on right ventricle. Arch Dis Child. 1971;46:623–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Conner AN. Early onset scoliosis: a call for awareness. Br Med J (Clin Res Ed). 1984;289:962–3.

    Article  CAS  Google Scholar 

  19. Dickson RA. The aetiology of spinal deformities. Lancet. 1988;1:1151–5.

    Article  CAS  PubMed  Google Scholar 

  20. Robinson CM, McMaster MJ. Juvenile idiopathic scoliosis. Curve patterns and prognosis in one hundred and nine patients. J Bone Joint Surg Am. 1996;78:1140–8.

    Article  CAS  PubMed  Google Scholar 

  21. King HA, Moe JH, Bradford DS, Winter RB. The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am. 1983;65:1302–13.

    Article  CAS  PubMed  Google Scholar 

  22. Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83-A:1169–81.

    Article  CAS  PubMed  Google Scholar 

  23. Lenke LG, Betz RR, Bridwell KH, et al. Spontaneous lumbar curve coronal correction after selective anterior or posterior thoracic fusion in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 1999;24:1663–71; discussion 1672.

    Article  CAS  Google Scholar 

  24. Kuklo TR, Lenke LG, Won DS, et al. Spontaneous proximal thoracic curve correction after isolated fusion of the main thoracic curve in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2001;26:1966–75.

    Article  CAS  Google Scholar 

  25. Lenke LG, Betz RR, Haher TR, et al. Multisurgeon assessment of surgical decision-making in adolescent idiopathic scoliosis: curve classification, operative approach, and fusion levels. Spine (Phila Pa 1976). 2001;26:2347–53.

    Article  CAS  Google Scholar 

  26. Lenke LG, Betz RR, Clements D, et al. Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment? Spine (Phila Pa 1976). 2002;27:604–11.

    Article  Google Scholar 

  27. Lenke LG, 2nd Edwards CC, Bridwell KH. The Lenke classification of adolescent idiopathic scoliosis: how it organizes curve patterns as a template to perform selective fusions of the spine. Spine (Phila Pa 1976). 2003;28:S199–207.

    Article  Google Scholar 

  28. Newton PO, Faro FD, Lenke LG, et al. Factors involved in the decision to perform a selective versus nonselective fusion of Lenke 1B and 1C (King-Moe II) curves in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2003;28:S217–23.

    Article  Google Scholar 

  29. Dobbs MB, Lenke LG, Walton T, et al. Can we predict the ultimate lumbar curve in adolescent idiopathic scoliosis patients undergoing a selective fusion with undercorrection of the thoracic curve? Spine (Phila Pa 1976). 2004;29:277–85.

    Article  Google Scholar 

  30. Duong L, Cheriet F, Labelle H, et al. Interobserver and intraobserver variability in the identification of the Lenke classification lumbar modifier in adolescent idiopathic scoliosis. J Spinal Disord Tech. 2009;22:448–55.

    Article  PubMed  Google Scholar 

  31. 2nd Edwards CC, Lenke LG, Peelle M, et al. Selective thoracic fusion for adolescent idiopathic scoliosis with C modifier lumbar curves: 2- to 16-year radiographic and clinical results. Spine (Phila Pa 1976). 2004;29:536–46.

    Article  Google Scholar 

  32. Adams W. Lectures on pathology and treatment of lateral and other forms of curvature of the spine. London: Churchill; 1865.

    Google Scholar 

  33. Cobb J. Outline for the study of scoliosis. Instructional course lectures. Am Acad Orthop Surg. 1948;5:261–75.

    Google Scholar 

  34. Nash Jr CL, Moe JH. A study of vertebral rotation. J Bone Joint Surg Am. 1969;51:223–9.

    Article  PubMed  Google Scholar 

  35. Lam GC, Hill DL, Le LH, et al. Vertebral rotation measurement: a summary and comparison of common radiographic and CT methods. Scoliosis. 2008;3:16-7161-3-16.

    Google Scholar 

  36. Ceballos T, Ferrer-Torrelles M, Castillo F, Fernandez-Paredes E. Prognosis in infantile idiopathic scoliosis. J Bone Joint Surg Am. 1980;62:863–75.

    Article  CAS  PubMed  Google Scholar 

  37. Lonstein JE, Carlson JM. The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am. 1984;66:1061–71.

    Article  CAS  PubMed  Google Scholar 

  38. Risser JC. The Iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop. 1958;11:111–9.

    CAS  PubMed  Google Scholar 

  39. Greulich W, Pyle S. Radiographic Atlas of skeletal development of the hand and wrist. 2nd ed. Stanford: Stanford University Press; 1959.

    Google Scholar 

  40. Horter MJ, Friesen S, Wacker S, et al. Determination of skeletal age : comparison of the methods of Greulich and Pyle and Tanner and Whitehouse. Orthopade. 2012;41:966–76.

    Article  CAS  PubMed  Google Scholar 

  41. Hackman L, Black S. The reliability of the Greulich and Pyle atlas when applied to a modern Scottish population. J Forensic Sci. 2013;58:114–9.

    Article  PubMed  Google Scholar 

  42. Paxton ML, Lamont AC, Stillwell AP. The reliability of the Greulich-Pyle method in bone age determination among Australian children. J Med Imaging Radiat Oncol. 2013;57:21–4.

    Article  PubMed  Google Scholar 

  43. Tanner JM, Whitehouse RH, Takaishi M. Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. I. Arch Dis Child. 1966;41:454–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Tanner JM, Whitehouse RH, Takaishi M. Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II. Arch Dis Child. 1966;41:613–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Stokes IA, Laible JP. Three-dimensional osseo-ligamentous model of the thorax representing initiation of scoliosis by asymmetric growth. J Biomech. 1990;23:589–95.

    Article  CAS  PubMed  Google Scholar 

  46. Mehta MH. The rib-vertebra angle in the early diagnosis between resolving and progressive infantile scoliosis. J Bone Joint Surg Br. 1972;54:230–43.

    CAS  PubMed  Google Scholar 

  47. Kristmundsdottir F, Burwell RG, James JI. The rib-vertebra angles on the convexity and concavity of the spinal curve in infantile idiopathic scoliosis. Clin Orthop Relat Res. 1985;201:205–9.

    Google Scholar 

  48. Ward K, Ogilvie JW, Singleton MV, et al. Validation of DNA-based prognostic testing to predict spinal curve progression in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2010;35:E1455–64.

    Article  Google Scholar 

  49. Ogilvie JW. Update on prognostic genetic testing in adolescent idiopathic scoliosis (AIS). J Pediatr Orthop. 2011;31:S46–8.

    Article  PubMed  Google Scholar 

  50. Cahill KS, Wang MY. DNA-based prediction of scoliosis curve progression. World Neurosurg. 2011;76:371.

    Article  PubMed  Google Scholar 

  51. Carlson B, ScoliScore AIS. Prognostic test personalizes treatment for children with spinal curve. Biotechnol Healthc. 2011;8:30–1.

    PubMed  PubMed Central  Google Scholar 

  52. Rinsky LA, Gamble JG. Adolescent idiopathic scoliosis. West J Med. 1988;148:182–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Rinsky LA. Advances in management of idiopathic scoliosis. Hosp Pract (Off Ed). 1992;27:49–55.

    Article  CAS  Google Scholar 

  54. Roach JW. Adolescent idiopathic scoliosis. Orthop Clin North Am. 1999;30:353–65, vii–viii.

    Article  CAS  PubMed  Google Scholar 

  55. Reamy BV, Slakey JB. Adolescent idiopathic scoliosis: review and current concepts. Am Fam Physician. 2001;64:111–6.

    CAS  PubMed  Google Scholar 

  56. Negrini S, Antonini G, Carabalona R, Minozzi S. Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review. Pediatr Rehabil. 2003;6:227–35.

    Article  PubMed  Google Scholar 

  57. Fusco C, Zaina F, Atanasio S, et al. Physical exercises in the treatment of adolescent idiopathic scoliosis: an updated systematic review. Physiother Theory Pract. 2011;27:80–114.

    Article  CAS  PubMed  Google Scholar 

  58. Lonstein JE, Winter RB. The Milwaukee brace for the treatment of adolescent idiopathic scoliosis. A review of one thousand and twenty patients. J Bone Joint Surg Am. 1994;76:1207–21.

    Article  CAS  PubMed  Google Scholar 

  59. Shaughnessy WJ. Advances in scoliosis brace treatment for adolescent idiopathic scoliosis. Orthop Clin North Am. 2007;38:469–75. v.

    Article  PubMed  Google Scholar 

  60. Schiller JR, Thakur NA, Eberson CP. Brace management in adolescent idiopathic scoliosis. Clin Orthop Relat Res. 2010;468:670–8.

    Article  PubMed  Google Scholar 

  61. Wickers FC, Bunch WH, Barnett PM. Psychological factors in failure to wear the Milwaukee brace for treatment of idiopathic scoliosis. Clin Orthop Relat Res. 1977;126:62–6.

    Google Scholar 

  62. Climent JM, Sanchez J. Impact of the type of brace on the quality of life of Adolescents with Spine Deformities. Spine (Phila Pa 1976). 1999;24:1903–8.

    Article  CAS  Google Scholar 

  63. Dickson JH, Erwin WD, Rossi D. Harrington instrumentation and arthrodesis for idiopathic scoliosis. A twenty-one-year follow-up. J Bone Joint Surg Am. 1990;72:678–83.

    Article  CAS  PubMed  Google Scholar 

  64. Dimeglio AB, La F. Rachis En Croissance. Paris: Springer; 1990.

    Google Scholar 

  65. Akbarnia BA, Marks DS, Boachie-Adjei O, et al. Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine (Phila Pa 1976). 2005;30:S46–57.

    Article  Google Scholar 

  66. Bernstein RM, Hall JE. Solid rod short segment anterior fusion in thoracolumbar scoliosis. J Pediatr Orthop B. 1998;7:124–31.

    Article  CAS  PubMed  Google Scholar 

  67. Betz RR, Harms J, 3rd Clements DH. Comparison of anterior and posterior instrumentation for correction of adolescent thoracic idiopathic scoliosis. Spine (Phila Pa 1976). 1999;24:225–39.

    Article  CAS  Google Scholar 

  68. Kim YB, Lenke LG, Kim YJ, et al. The morbidity of an anterior thoracolumbar approach: adult spinal deformity patients with greater than five-year follow-up. Spine (Phila Pa 1976). 2009;34:822–6.

    Article  Google Scholar 

  69. Newton PO, Upasani VV, Lhamby J, et al. Surgical treatment of main thoracic scoliosis with thoracoscopic anterior instrumentation. Surgical technique. J Bone Joint Surg Am. 2009;91 Suppl 2:233–48.

    Article  PubMed  Google Scholar 

  70. Izatt MT, Adam CJ, Labrom RD, Askin GN. The relationship between deformity correction and clinical outcomes after thoracoscopic scoliosis surgery: a prospective series of one hundred patients. Spine (Phila Pa 1976). 2010;35:E1577–85.

    Article  Google Scholar 

  71. Davies G, Reid L. Growth of the alveoli and pulmonary arteries in childhood. Thorax. 1970;25:669–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Thurlbeck WM. Postnatal human lung growth. Thorax. 1982;37:564–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Merkus PJ, ten Have-Opbroek AA, Quanjer PH. Human lung growth: a review. Pediatr Pulmonol. 1996;21:383–97.

    Article  CAS  PubMed  Google Scholar 

  74. Jarzem PF, Gledhill RB. Predicting height from arm measurements. J Pediatr Orthop. 1993;13:761–5.

    Article  CAS  PubMed  Google Scholar 

  75. Cheng JC, Leung SS, Chiu BS, et al. Can we predict body height from segmental bone length measurements? A study of 3,647 children. J Pediatr Orthop. 1998;18:387–93.

    CAS  PubMed  Google Scholar 

  76. Frick SL. Scoliosis in children with anterior chest wall deformities. Chest Surg Clin N Am. 2000;10:427–36.

    CAS  PubMed  Google Scholar 

  77. Hong JY, Suh SW, Park HJ, et al. Correlations of adolescent idiopathic scoliosis and pectus excavatum. J Pediatr Orthop. 2011;31:870–4.

    Article  PubMed  Google Scholar 

  78. Emil S, Laberge JM, Sigalet D, Baird R. Pectus carinatum treatment in Canada: current practices. J Pediatr Surg. 2012;47:862–6.

    Article  PubMed  Google Scholar 

  79. Lee RT, Moorman S, Schneider M, Sigalet DL. Bracing is an effective therapy for pectus carinatum: interim results. J Pediatr Surg. 2013;48:184–90.

    Article  PubMed  Google Scholar 

  80. Campbell Jr RM. Spine deformities in rare congenital syndromes: clinical issues. Spine (Phila Pa 1976). 2009;34:1815–27.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria

    Christine Wibmer MD

  2. Pediatric Orthopedic Unit, Department of Pediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, A-8036, Graz, Austria

    Vinay Saraph MD

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  1. Christine Wibmer MD
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  2. Vinay Saraph MD
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Correspondence to Vinay Saraph MD .

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  1. Consultant Pediatric Surgeon Chelsea Children’s Hospital, Chelsea and Westminster Hospital NHS Foundation Trust Imperial College London, London, United Kingdom

    Amulya K. Saxena

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Wibmer, C., Saraph, V. (2017). Idiopathic Scoliosis. In: Saxena, A. (eds) Chest Wall Deformities. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53088-7_10

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