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{{Scoliosis}}
{{Scoliosis}}


{{CMG}}; {{AE}}Humayun Israr ,Mbbs  
{{CMG}}; {{AE}}{{Rohan}}  
==Classification==
==Classification==
Scoliosis can be  classified into congenital scoliosis (due to failure of vertebral formation or segmentation of affected vertebrae), idiopathic scoliosis(when the cause is not known) or neuromuscular scoliosis (due to loss of muscle strength or voluntary  muscle control).
[[Scoliosis]] can be  classified into [[congenital scoliosis]] (due to failure of [[Vertebra|vertebral]] formation or segmentation of affected [[Vertebra|vertebrae]]), [[idiopathic]] [[scoliosis]](when the cause is not known) or [[Neuromuscular|neuromuscular scoliosis]] (due to loss of [[Muscle|muscle strength]] or voluntary  muscle control).
* Congenital scoliosis is subdivided based on radiological finding, combined structural component involved and 3-D CT.
 
=== Congenital Scoliosis ===
{| align="right"
|
[[File:Hemivertebra-with-congenital-scoliosis.jpg|200px|thumb|Right supernumerary D10/D11 hemivertebra is noted associated with mild right dorsal scoliosis as well as mild focal kyphotic deformity. [https://radiopaedia.org/cases/hemivertebra-with-congenital-scoliosis-3Source: Case courtesy of Dr Mohammad A. ElBeialy, Radiopaedia.org, rID: 41542]]]
|}
* [[Scoliosis|Congenital scoliosis]] is subdivided based on radiological finding, combined structural component involved and 3-D CT.<ref>{{cite journal |last1=Winter |first1=RB |last2=Moe |first2=JH |date=1960,Jan 01 |title=Congenital Scoliosis A Study of 234 Patients Treated and Untreated Part I: Natural History |url= |journal=J Bone Joint Surg Am. |volume=50 |issue=1 |page=1-15 |doi= |pmc= |pmid= |access-date= | name-list-format=vanc }}</ref><ref>{{cite journal |last1=Imagama |first1=S |last2=Kawakami |first2=N |date=2005 |title=Spatial relationships between a deformed vertebra and an adjacent vertebra in congenial scoliosis-failure of formation. |url= |journal=J Jpn Scoliosis Soc. |volume=20 |issue= |pages=20-25 |doi= |pmc= |pmid= |access-date= | name-list-format=vanc }}</ref>
 
{| class="wikitable"
{| class="wikitable"
|+<big>Based on radiological finding</big>
|+<big>Based on radiological finding</big>
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|Semisegmented hemilamina
|Semisegmented hemilamina
|-
|-
|Spina bifida
|[[Spina bifida]]
|-
|-
|Bilamina (complete or incomplete)
|Bilamina (complete or incomplete)
Line 40: Line 47:
|Wedged lamina
|Wedged lamina
|-
|-
|Spina bifida
|[[Spina bifida]]
|-
|-
|Lateral wedged vertebra (bipedicle)
|Lateral wedged vertebra (bipedicle)
Line 47: Line 54:
{| class="wikitable"
{| class="wikitable"
|+Based on 3-D CT
|+Based on 3-D CT
!
!
|-
|-
|Type 1
|Type 1
|Solitary simple congenital malformation (unison)
|Solitary simple congenital malformation (unison)
* hemivertebra
* Hemivertebra
* wedged vertebra
* Wedged vertebra
* butterfly vertebra
* Butterfly vertebra
* others
* Others
|-
|-
|Type 2
|Type 2
|Multiple simple anomalies (unison)
|Multiple simple anomalies (unison)
* combination of hemivertebra, wedged vertebra and butterfly vertebra
* Combination of hemivertebra, wedged vertebra and butterfly vertebra
* discreet, adjacent or others
* Discreet, adjacent or others
|-
|-
|Type 3
|Type 3
|Complex anomalies (discordant)
|Complex anomalies (discordant)
* mixed failure
* Mixed failure
|-
|-
|Type 4
|Type 4
|Segmentation failure only
|Segmentation failure only
|}
|}
*Idiopathic scoliosis may be further classified into three types based on age of onset.   
 
**infantile idipathic scoliosis (birth to 3 years)
=== Idiopathic Scoliosis ===
**juvenile idiopathic scoliosis (4 to 9 years)
{| align="right"
**adolescent idiopathic scoliosis (10 to 20 years)
|
[[File:Idiopathic Scoliosis.JPG|200px|thumb|Idiopathic Thoracolumbar scoliosis. Source: Case courtesy by: [[User:Rohan Bhimani|Dr. Rohan A. Bhimani]]]]
|}
*[[Idiopathic scoliosis]] may be further classified into three types based on age of onset and anatomical level involved.<ref>Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.</ref><ref name="pmid6654943">{{cite journal| author=King HA, Moe JH, Bradford DS, Winter RB| title=The selection of fusion levels in thoracic idiopathic scoliosis. | journal=J Bone Joint Surg Am | year= 1983 | volume= 65 | issue= 9 | pages= 1302-13 | pmid=6654943 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6654943 }} </ref>
 
======Based on Age of Onset======
*Infantile [[Scoliosis|idipathic scoliosis]] (birth to 3 years)
*[[Juvenile (organism)|Juvenile]] [[idiopathic scoliosis]] (4 to 9 years)
*[[Adolescent idiopathic scoliosis]] (10 to 20 years)
 
======Based on Anatomical Level Involved======
King and Moe defined five curve types:
 
*Type 1: an S shape deformity, in which both curves are structural and cross the CSVL, with the [[Lumbar|lumbar curve]] being larger than the thoracic one
*Type 2: an S shape deformity, in which both curves are structural and cross the CSVL, with the [[Thoracic|thoracic curve]] being larger or equal to the [[lumbar]] one
*Type 3: major [[thoracic]] curve in which only the thoracic curve is structural and crosses the CSVL
*Type 4: long C shape thoracic curve in which the fifth [[lumbar]] vertebra is centered over the [[sacrum]] and the fourth [[lumbar]] vertebra is tilted into the thoracic curve
*Type 5: double [[thoracic]] curve
 
=== Neuromuscular Scoliosis ===
*Neuromuscular scoliosis can be further subdivided based on the classification of scoliosis research society.<ref name="McCarthy1999">{{cite journal|last1=McCarthy|first1=Richard E.|title=MANAGEMENT OF NEUROMUSCULAR SCOLIOSIS|journal=Orthopedic Clinics of North America|volume=30|issue=3|year=1999|pages=435–449|issn=00305898|doi=10.1016/S0030-5898(05)70096-1}}</ref>
**Primary neuropathies
**Upper motor neuron neuropathies
***[[Cerebral palsy]]
***Spinocerebellar degeneration
****[[Friedreich's ataxia|Friedreich ataxia]]
****[[Roussy-Levy disease]]
****[[Spinocerebellar ataxia]]
***[[Syringomyelia]]
***[[Spinal cord tumor]]
***[[Spinal cord trauma]]
**Lower motor neuron neuropathies
***[[Poliomyelitis]]
***Other viral myelitides
***Traumatic
***[[Charcot-Marie-Tooth disease]]
***Spinal muscular atrophy
**** [[Werdnig-Hoffmann disease]] (SMA type 1)
**** [[Kugelberg-Welander disease]] (SMA type 2)
***Dysautonomia
**** [[Riley-Day syndrome]]
***Combined upper and lower pathologies
**** [[Amyotrophic lateral sclerosis]]
**** [[Myelomeningocele]]
**** Tether cord
**Primary myopathies
***Muscular dystrophy
**** [[Duchenne muscular dystrophy]]
**** Limb-girdle dystrophy
**** Facioscapulohumeral dystrophy
***[[Arthrogryposis]]
***Congenital [[hypotonia]]
***Myotonia dystrophica


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
campbells operative orthopaedics thirteenth ediion{{WH}}
 
{{WS}}
[[Category: (Orthopedics)]]
[[Category: (name of the system)]]

Latest revision as of 15:13, 10 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Classification

Scoliosis can be classified into congenital scoliosis (due to failure of vertebral formation or segmentation of affected vertebrae), idiopathic scoliosis(when the cause is not known) or neuromuscular scoliosis (due to loss of muscle strength or voluntary muscle control).

Congenital Scoliosis

Right supernumerary D10/D11 hemivertebra is noted associated with mild right dorsal scoliosis as well as mild focal kyphotic deformity. Case courtesy of Dr Mohammad A. ElBeialy, Radiopaedia.org, rID: 41542
Based on radiological finding
Complete failure - hemivertebra, butterfly vertebra
Failure of formation Partial failure - wedged vertebra
Unilateral failure - longitudinal failure
Failure of segmentation Bilateral failure - block vertebra
Miscellaneous Formation and segmentation mixed failure
Based on formation of error and the structural combining of the anterior and posterior vertebral component
Anterior component Posterior component
Hemivertebra (hemipedicle) Fully segmented hemilamina
Semisegmented hemilamina
Spina bifida
Bilamina (complete or incomplete)
Butterfly lamina (bipedicle) Wedged lamina
Spina bifida
Lateral wedged vertebra (bipedicle) Wedged Lamina
Based on 3-D CT
Type 1 Solitary simple congenital malformation (unison)
  • Hemivertebra
  • Wedged vertebra
  • Butterfly vertebra
  • Others
Type 2 Multiple simple anomalies (unison)
  • Combination of hemivertebra, wedged vertebra and butterfly vertebra
  • Discreet, adjacent or others
Type 3 Complex anomalies (discordant)
  • Mixed failure
Type 4 Segmentation failure only

Idiopathic Scoliosis

Idiopathic Thoracolumbar scoliosis. Source: Case courtesy by: Dr. Rohan A. Bhimani
Based on Age of Onset
Based on Anatomical Level Involved

King and Moe defined five curve types:

  • Type 1: an S shape deformity, in which both curves are structural and cross the CSVL, with the lumbar curve being larger than the thoracic one
  • Type 2: an S shape deformity, in which both curves are structural and cross the CSVL, with the thoracic curve being larger or equal to the lumbar one
  • Type 3: major thoracic curve in which only the thoracic curve is structural and crosses the CSVL
  • Type 4: long C shape thoracic curve in which the fifth lumbar vertebra is centered over the sacrum and the fourth lumbar vertebra is tilted into the thoracic curve
  • Type 5: double thoracic curve

Neuromuscular Scoliosis

References

  1. ↑ Winter RB, Moe JH (1960,Jan 01). "Congenital Scoliosis A Study of 234 Patients Treated and Untreated Part I: Natural History". J Bone Joint Surg Am. 50 (1): 1-15. Check date values in: |date= (help)
  2. ↑ Imagama S, Kawakami N (2005). "Spatial relationships between a deformed vertebra and an adjacent vertebra in congenial scoliosis-failure of formation". J Jpn Scoliosis Soc. 20: 20–25.
  3. ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.
  4. ↑ King HA, Moe JH, Bradford DS, Winter RB (1983). "The selection of fusion levels in thoracic idiopathic scoliosis". J Bone Joint Surg Am. 65 (9): 1302–13. PMID 6654943.
  5. ↑ McCarthy, Richard E. (1999). "MANAGEMENT OF NEUROMUSCULAR SCOLIOSIS". Orthopedic Clinics of North America. 30 (3): 435–449. doi:10.1016/S0030-5898(05)70096-1. ISSN 0030-5898.
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