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 beendeveloped. 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 curve <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 witha 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.