Scoliosis

Chapman Explained PREPARED BY DR. MAJID AL-HOMIEDAN

Chapman Explained Dr. Majid Al-Homiedan

Scoliosis

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Infantile idiopathic scoliosis diagnosed before the age

of 4 years. 90% are thoracic and concave to the right.  More common in boys. 90% resolve spontaneously.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Juvenile idiopathic scoliosis diagnosed between 4 and

10 years.  More common in girls. Almost always progressive.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Adolescent idiopathic scoliosis diagnosed between 10

years and maturity. More common in females. Majority are concave to the left in the thoracic region.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Failure of formation and Scoliosis  Incarcerated hemivertebra.

A straight spine with little tendency to progression.  B. Free hemivertebra. May be progressive.  C. Wedge vertebra. Better prognosis than a free hemivertebra.  D. Multiple hemivertebrae. Failure of formation on the same side results in a severe curve.  . E. Central defect. Butterfly vertebra

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Failure of Segmentation and Scoliosis A. Bilateral block

vertebra and a short spine, e.g. Klippel-Feil.  B. Unilateral unsegmented bar. Severely progressive curve with varying degrees of kyphosis or lordosis depending on the position of the bar

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Mixed defects and Scoliosis Unilateral unsegmented

bar and a hemivertebra. Severely progressive.  Partially segmented incarcerated hemivertebra.  Bilateral failure of segmentation Incorporating a hemivertebra

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Myelomeningocele and scoliosis Linked to neurological

impairment. Growth potential. Other vertebral anomalies.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Spinal Muscular Dystrophy and Scoliosis

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Friedreich’s Ataxia and scoliosis About 2/3 of patients

with FA develop scoliosis mainly due to muscle weakness. there’s speculation that frataxin gene deficiency might have direct effects on bone development.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Poliomyelitis and Scoliosis Viral invasion of motor

neurons leading to wallerian degeneration,muscle weakness and eventually scoliosis. Leg length discrepancy and limping is also another cause of scoliosis.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Cerebral Palsy and Scoliosis Whether flaccid or

spastic cerebral palsy both cause scoliosis.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Muscular Dystrophies and Scoliosis  Duchenne muscular dystrophy,

   

deficient gene that makes dystrophin. leading to muscle break-down and weakness. Becker muscular dystrophy Myotonic dystrophy. Limb-girdle muscular dystrophy Facioscapulohumeral muscular dystrophy

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Neurofibromatosis and Scoliosis  in up to 40% of patients  short, sharply angulated curve

-

-

which involve only few vertebra associated with: Neural foramina enlargement Rib penciling kyphosis Vertebral body scalloping Dural ectasia Soft tissue masses

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Marfan’s syndrome and scoliosis  scoliosis in 40-60%.

Double structural curves are typical.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Homocystinuria and Scoliosis  Inherited disorder of the

metabolism of the amino acid methionine.  Multisystemic disorder of the connective tissue, muscles, CNS, and cardiovascular system.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Scoliosis Post Radiotherapy Wedged and hypoplastic

vertebrae ± unilateral pelvic or rib hypoplasia

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Leg-length discrepancy and Scoliosis A flexible lumbar curve,

convex to the side of the shorter leg  Disparity of iliac crest level.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Osteoid Osteoma and Scoliosis 10% occur in the spine. A lamina or pedicle at the

apex of the curve will be sclerotic or over grown.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Osteoblastoma and Scoliosis  The spine is involved in

about 50 percent of cases and it usually arises in the posterior elements.  It typically causes dull pain and may be associated with scoliosis or nerve compression.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan