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Paediatric scoliosis: Update on assessment and treatment
1MBBS, FRACS (Ortho), Clinical Researcher, Biomechanics and Spine Research Group, Institute of Health and Biomedical Innovation, QUT, Qld; Adult and Paediatric Spine Surgeon, Queensland Children@s Hospital, Princess Alexandra Hospital, Greenslopes Private Hospital and The Wesley Hospital, Qld.
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.
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