Scoliosis and kyphoscoliosis

Daniel J Bonthius Jr BS (

Mr. Bonthius of the Medical University of South Carolina has no relevant financial relationships to disclose.

)
Daniel J Bonthius MD PhD (Dr. Bonthius of the University of Iowa has no relevant financial relationships to disclose.)
Michael V Johnston MD, editor. (

Dr. Johnston of Johns Hopkins University School of Medicine and Chief Medical Officer at Kennedy Krieger Institute has no relevant financial relationships to disclose.

)
Originally released October 17, 2011; last reviewed October 3, 2018; expires October 3, 2021

Overview

Scoliosis and kyphosis are deformities of the spine in the coronal and sagittal planes, respectively. These spinal deformities arise from multiple etiologies and are commonly observed in patients with neurologic and neuromuscular disorders. The spinal deformities may present with or without other signs and symptoms. In this article, the authors provide background knowledge helpful to neurologists caring for patients with spinal deformities. Differential diagnosis, treatment alternatives, and potential neurologic issues are described.

Key points

 

• Scoliosis and kyphosis, which are curvatures of the spine in the coronal and sagittal planes, respectively, are common among patients with neurologic and neuromuscular diseases.

 

• Idiopathic scoliosis is a diagnosis of exclusion but has stereotypical characteristics distinguishing it from known neuromuscular causes.

 

• Progression of scoliotic curves occurs most rapidly during phases of rapid linear body growth, particularly during infancy and adolescence.

 

• Scoliosis during infancy will usually resolve spontaneously.

 

• In adolescents with idiopathic scoliosis, bracing can substantially decrease the progression of high-risk curves to the threshold for surgery.

 

• Patients who do not have typical characteristics of idiopathic scoliosis and no known neuromuscular disorder require further evaluation, including spinal MRI.

Historical note and terminology

Scoliosis and kyphosis were recognized by several ancient civilizations and were first described by the Greek physician Hippocrates. It wasn t until the mid-twentieth century that the first reliable treatments began to emerge, including the Milwaukee brace and Harrington rods. These treatments laid the foundation for modern scoliosis treatments today (Linker 2012).

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