Idiopathic adolescent scoliosis

Question 1

Features

Answer 1

The vast majority of curves

• occurring equally in boys and girls
• mild and of no consequence.

85% of significant curves in adolescent scoliosis occur in girls.

Such curves appear during the peripubertal period

• usu. coinciding with the growth spurt.

The screening test (usu. in 11–13 yo) is to note the contour of the back on forward flexion.

10% of normal adolescents have a curve of >5%

• but only 1–2% >10%.

Question 2

Screening for idiopathic adolescent scoliosis:

Answer 2

testing asymmetry by forward flexion

Question 3

General rules for Cobb angle

Answer 3

<20° observe

20–40° brace

>40° surgery

Question 4

Investigation

Answer 4

A single erect PA spinal X-ray is sufficient;

• the Cobb angle is the usual measurement yardstick.

Question 5

Management aims

Answer 5

Preserve good appearance—level shoulders and no trunk shift

Prevent increasing curve in adult life: <40°

Not to produce a straight spine on X-ray

Refer for expert opinion