Scoliosis

Basics

DESCRIPTION

Coronal plane deformity (lateral curvature) of spine exceeding 10 degrees on radiographs with associated rotational deformity of the spine

EPIDEMIOLOGY

Adolescent idiopathic scoliosis

  • Female-to-male ratios:
    • 1.4:1 for curves 11 to 20 degrees
    • 5.4:1 for curves >20 degrees

PREVALENCE

  • 1–4% of population for curves ≥10 degrees
  • 0.3–0.5% of population have curves >20 degrees.

RISK-FACTORS

  • Positive familial history of idiopathic scoliosis in 30% (not predictive of severity)
  • Females have higher prevalences of larger and progressive idiopathic scoliosis.
  • Persons with underlying conditions (e.g., Marfan syndrome, spina bifida, cerebral palsy) have increased risk for development of scoliosis.

GENETICS

Under investigation: Several candidate genes have been identified.

ETIOLOGY

  • Connective tissue disorder
    • Associated with several connective tissue disorders (including Marfan syndrome, Ehlers-Danlos syndrome)
    • Alterations in connective tissue of the spine, paraspinous muscles, and platelets
    • May be related to decreased bone mineral density of vertebral bodies
  • Neurologic (equilibrium system)
    • Abnormalities noted in vestibular, ocular, proprioceptive, and vibratory functions
  • Hormonal
    • Lower melatonin levels secreted from pineal body in those with adolescent idiopathic scoliosis
    • Growth hormone: more of an influential factor than an etiologic factor in studies
  • Vertebral growth abnormalities
    • Asymmetric growth rates between the right and left sides of the spine

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