Scoliosis (Idiopathic)
Basics
Description
- Scoliosis: lateral curvature of spine exceeding 10 degrees on PA full-spine radiograph (with rotation of spine); curves <10 are termed spinal asymmetry; considered idiopathic only after other causes have been excluded
- Kyphosis: anteriorly concave curvature of vertebral column
Epidemiology
- Female-to-male ratios:
- 1.4:1 for curves 11–20 degrees
- 5.4:1 for curves >20 degrees
Prevalence
- Generally considered 1.5–3% for curves ≥10 degrees
- 0.3–0.5% for curves >20 degrees
Risk Factors
Genetics
Positive familial history for idiopathic scoliosis in 30% (not predictive of severity)
- Under active investigation: GWAS and whole exome sequencing studies
- Several candidate genes have been identified.
Etiology
By definition, unknown; listed are some theories, none proven in isolation:
- Genetic
- Positive familial history for scoliosis in 30% (not predictive of severity)
- Connective tissue disorder
- Associated with several connective tissue disorders (including Marfan syndrome, Ehlers-Danlos syndrome, etc.)
- Alterations in connective tissue of the spine, paraspinous muscles, and platelets
- May be related to osteopenia (decreased bone mineral density) of vertebral bodies
- Neurologic (equilibrium system)
- Abnormalities noted in vestibular, ocular, proprioceptive, and vibratory functions
- Hormonal
- Lower levels of melatonin 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
Commonly Associated Conditions
- Connective tissue disorders, including Marfan syndrome and Ehlers-Danlos syndrome
- Neurofibromatosis
- Neuromuscular conditions, including cerebral palsy, spina bifida, spinal muscular atrophy, Friedreich ataxia, etc.
- If any of these conditions are present, the diagnosis is no longer idiopathic.
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Citation
Cabana, Michael D., editor. "Scoliosis (Idiopathic)." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14026/all/Scoliosis__Idiopathic_.
Scoliosis (Idiopathic). In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14026/all/Scoliosis__Idiopathic_. Accessed May 29, 2023.
Scoliosis (Idiopathic). (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14026/all/Scoliosis__Idiopathic_
Scoliosis (Idiopathic) [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 May 29]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14026/all/Scoliosis__Idiopathic_.
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