Scoliosis
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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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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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