Scoliosis

Abstract

Scoliosis is a structural three-dimensional deformation of the spine with coronal Cobb angle greater than 10°. Clinicians must indagate the age of onset, family history of scoliosis, pain, and menarchal status. The diagnosis of scoliosis is clinical. Trunk asymmetry and rib prominence are common characteristics that could be observed during clinical examinations. X-ray is essential to confirm the diagnosis, carry out surveillance, and establish the prognosis and therapeutic indication. Cobb angle, spinal rotation, and assessment of spinal maturation are evaluated by X-ray. It could be idiopathic or caused by other conditions (secondary scoliosis) and could be defined as neuromuscular, congenital, malformative, or syndromic scoliosis. The natural evolution of scoliosis is progression with growth and then a stabilization from skeletal maturity. The main goal is to avoid progression deformity and reach skeletal maturity with mild balanced scoliosis, likely to remain stable throughout adulthood and to allow a normal, active life. A correction of the deformity is more difficult to obtain with nonoperative management. Bracing is the main treatment of scoliosis in children and adolescents. Operative treatment consists of correcting the deformity and fusing the affected spinal segment to prevent recurrence and progression. Surgery is offered in cases of progressive scoliosis not controlled by brace treatment or scoliosis presenting a significant risk of progression in adulthood.