Scoliosis classification

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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

Congenital scoliosis is subdivided based on radiological finding, combined structural component involved and 3-D CT.^[1]^[2]

Based on radiological finding
	Complete failure - hemivertebra, butterfly vertebra
Failure of formation	Partial failure - wedged vertebra
Failure of formation	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
Butterfly lamina (bipedicle)	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

Idiopathic scoliosis may be further classified into three types based on age of onset and anatomical level involved.^[3]^[4]

Based on Age of Onset

Infantile idipathic scoliosis (birth to 3 years)
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 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 forth 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.^[5]
- Primary neuropathies
- Upper motor neuron neuropathies
  - Cerebral palsy
  - Spinocerebellar degeneration
  - 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

↑ 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)
↑ 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.
↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.
↑ 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.
↑ 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.

[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.

[pmid6654943-4] 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.

[McCarthy1999-5] 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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