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  • Updated 10.17.2011
  • Released 10.17.2011
  • Expires For CME 10.17.2014

Scoliosis and kyphoscoliosis

Introduction

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. In this updated article, the authors provide background knowledge helpful to neurologists caring for patients with spinal deformities. The biological basis for spinal deformities is discussed and the differential diagnosis, management, and potential neurologic complications 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 (26).

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