Paediatric scoliosis: Update on assessment and treatment

Abstract

BACKGROUND: Paediatric scoliosis is a common condition seen by general practitioners. Structural scoliosis is characterised by axial rotation at the apex. Several new operative treatments have recently been developed. OBJECTIVE: The aim of this article is to give an overview of scoliosis diagnosis, assessment and management. DISCUSSION: Scoliosis assessment should identify structural curves, underlying causes, severity and growth potential. Atypical curves and red flags must be excluded. Observation is appropriate for curves <20° in patients with high growth potential (Risser 0-2) and curves <40° in patients with minimal growth potential (Risser 3-5). Bracing is appropriate for patients with a curve of 20-40° with high growth potential. Indications for surgery vary depending on patient and curve factors; however, surgery can be indicated when the curve is >40°. Surgery can be divided into three groups: growth modulation, instrumentation without fusion and instrumentation with fusion. Early diagnosis and referral to a paediatric spine service can improve outcomes.L6335604132020-12-08 <br />2021-08-12 <br />