Chapter 671 The Spine
Table 671-1 CLASSIFICATION OF SPINAL DEFORMITIES
SCOLIOSIS
Idiopathic
Congenital
Neuromuscular
Myopathies
Syndromes
Compensatory
KYPHOSIS
Adapted from the Terminology Committee, Scoliosis Research Society: A glossary of scoliosis terms, Spine 1:57, 1976.
671.1 Idiopathic Scoliosis
Clinical Manifestations
Barsdorf AI, Sproule DM, Kaufman P. Scoliosis surgery in children with neuromuscular disease. Arch Neurol. 2010;67:231-235.
Bunge EM, Juttmann RE, van Biezen FC, et al. Estimating the effectiveness of screening for scoliosis: a case-control study. Pediatrics. 2008;121:9-14.
de Lind van Wijngaarden RFA, de Klerk LWL, Festen DAM, et al. Scoliosis in Prader-Willi syndrome: prevalence, effects of age, gender, body mass index, lean body mass and genotype. Arch Dis Child. 2008;93:1012-1016.
Dolan LA, Weinstein SL. Surgical rates after observation and bracing for adolescent idiopathic scoliosis: an evidence based review. Spine. 2007;32:S91-S100.
Gillingham B, Fan RA, Akbarnia BA. Early onset idiopathic scoliosis. J Am Acad Orthop Surg. 2006;14:101-112.
Kallmes D, Jarvik JG. Spinal augmentation research: free at last? Lancet. 2009;373:982-984.
Katz DE, Herring JA, Browne RH, et al. Brace wear control of curve progression in adolescent idiopathic scoliosis. J Bone Joint Surg Am. 2010;92:1343-1352.
Kim YJ, Lenke LJ, Kim J, et al. Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine. 2006;31:291-298.
Merola AA, Haher TR, Brkaric M, et al. A multi-center study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument. Spine. 2002;27:2046-2051.
Negrini S, Minozzi S, Bettany-Saltikov J, et al: Braces for idiopathic scoliosis in adolescents (review), Cochrane Database Rev (1):CD006850, 2010.
Richards BS, Vitale MG. Screening for idiopathic scoliosis in adolescents. An information statement. J Bone Joint Surg Am. 2008;90:195-198.
Tones M, Moss N, Polly DWJr. A review of quality of life and psychosocial issues in scoliosis. Spine. 2006;31:3027-3028.
Weinstein SL, Dolan LA, Cheng JCY, et al. Adolescent idiopathic scoliosis. Lancet. 2008;371:1527-1536.
Weinstein SL, Dolan LA, Spratt KF, et al. Health and function of patients with untreated idiopathic scoliosis. JAMA. 2003;289:559-567.
Wright JG, Donaldson S, Howard A, et al. Are surgeon’s preferences for instrumentation related to outcomes? A randomized clinical trial of two implants for idiopathic scoliosis. J Bone Joint Surg Am. 2007;89:2684-2693.
671.2 Congenital Scoliosis

Figure 671-5 The defects of segmentation and formation that can occur during spinal development.
(From McMaster MJ: Congenital scoliosis. In Weinstein SL, editor: The pediatric spine: principles and practice, ed 2, Philadelphia, 2001, Lippincott Williams & Wilkins, p 163.)
Approximately 20-40% of patients have an intraspinal anomaly. Infants with cutaneous abnormalities overlying the spine might benefit from ultrasonography to rule out an occult spinal dysraphic condition. MRI is usually recommended during the course of treatment. Spinal dysraphism is the general term applied to such lesions (Chapters 585 and 598). Examples include diastematomyelia, split cord malformations, intraspinal lipomas (intradural or extradural), arachnoid cysts, teratomas, dermoid sinuses, fibrous bands, and tight filum terminale. Cutaneous findings that may be seen in patients with closed spinal dysraphism include hair patches, skin tags or dimples, sinuses, and hemangiomas. Most of these lesions become clinically evident through tethering of the spinal cord, the symptoms of which include back and/or leg pain, calf atrophy, progressive unilateral foot deformity (especially cavovarus), and problems with bowel or bladder function.