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{{Scoliosis}}
{{Scoliosis}}


{{CMG}}; {{AE}}{{Rohan}} 
==Classification==
[[Scoliosis]] can be  classified into [[congenital scoliosis]] (due to failure of [[Vertebra|vertebral]] formation or segmentation of affected [[Vertebra|vertebrae]]), [[idiopathic]] [[scoliosis]](when the cause is not known) or [[Neuromuscular|neuromuscular scoliosis]] (due to loss of [[Muscle|muscle strength]] or voluntary  muscle control).


{{CMG}}; {{AE}}
=== Congenital Scoliosis ===
==Overview==
{| align="right"
There is no established system for the classification of [disease name].
|
 
[[File:Hemivertebra-with-congenital-scoliosis.jpg|200px|thumb|Right supernumerary D10/D11 hemivertebra is noted associated with mild right dorsal scoliosis as well as mild focal kyphotic deformity. [https://radiopaedia.org/cases/hemivertebra-with-congenital-scoliosis-3Source: Case courtesy of Dr Mohammad A. ElBeialy, Radiopaedia.org, rID: 41542]]]
OR
|}
 
* [[Scoliosis|Congenital scoliosis]] is subdivided based on radiological finding, combined structural component involved and 3-D CT.<ref>{{cite journal |last1=Winter |first1=RB |last2=Moe |first2=JH |date=1960,Jan 01 |title=Congenital Scoliosis A Study of 234 Patients Treated and Untreated Part I: Natural History |url= |journal=J Bone Joint Surg Am. |volume=50 |issue=1 |page=1-15 |doi= |pmc= |pmid= |access-date= | name-list-format=vanc }}</ref><ref>{{cite journal |last1=Imagama |first1=S |last2=Kawakami |first2=N |date=2005 |title=Spatial relationships between a deformed vertebra and an adjacent vertebra in congenial scoliosis-failure of formation. |url= |journal=J Jpn Scoliosis Soc. |volume=20 |issue= |pages=20-25 |doi= |pmc= |pmid= |access-date= | name-list-format=vanc }}</ref>
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
 
OR


[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
{| class="wikitable"
[Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
|+<big>Based on radiological finding</big>
|
|Complete failure - hemivertebra, butterfly vertebra
|-
| rowspan="2" |Failure of formation
|Partial failure - wedged vertebra
|-
|Unilateral failure - longitudinal failure
|-
|Failure of segmentation
|Bilateral failure - block vertebra
|-
|Miscellaneous
|Formation and segmentation mixed failure
|}
{| class="wikitable"
|+
Based on formation of error and the structural combining of the anterior and posterior vertebral component
!Anterior component
!Posterior component
|-
| rowspan="4" |Hemivertebra (hemipedicle)
|Fully segmented hemilamina
|-
|Semisegmented hemilamina
|-
|[[Spina bifida]]
|-
|Bilamina (complete or incomplete)
|-
| rowspan="2" |Butterfly lamina (bipedicle)
|Wedged lamina
|-
|[[Spina bifida]]
|-
|Lateral wedged vertebra (bipedicle)
|Wedged Lamina
|}
{| class="wikitable"
|+Based on 3-D CT
|-
|Type 1
|Solitary simple congenital malformation (unison)
* Hemivertebra
* Wedged vertebra
* Butterfly vertebra
* Others
|-
|Type 2
|Multiple simple anomalies (unison)
* Combination of hemivertebra, wedged vertebra and butterfly vertebra
* Discreet, adjacent or others
|-
|Type 3
|Complex anomalies (discordant)
* Mixed failure
|-
|Type 4
|Segmentation failure only
|}


OR
=== Idiopathic Scoliosis ===
{| align="right"
|
[[File:Idiopathic Scoliosis.JPG|200px|thumb|Idiopathic Thoracolumbar scoliosis. Source: Case courtesy by: [[User:Rohan Bhimani|Dr. Rohan A. Bhimani]]]]
|}
*[[Idiopathic scoliosis]] may be further classified into three types based on age of onset and anatomical level involved.<ref>Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.</ref><ref name="pmid6654943">{{cite journal| author=King HA, Moe JH, Bradford DS, Winter RB| title=The selection of fusion levels in thoracic idiopathic scoliosis. | journal=J Bone Joint Surg Am | year= 1983 | volume= 65 | issue= 9 | pages= 1302-13 | pmid=6654943 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6654943  }} </ref>


Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
======Based on Age of Onset======
*Infantile [[Scoliosis|idipathic scoliosis]] (birth to 3 years)
*[[Juvenile (organism)|Juvenile]] [[idiopathic scoliosis]] (4 to 9 years)
*[[Adolescent idiopathic scoliosis]] (10 to 20 years)


OR
======Based on Anatomical Level Involved======
King and Moe defined five curve types:


If the staging system involves specific and characteristic findings and features:
*Type 1: an S shape deformity, in which both curves are structural and cross the CSVL, with the [[Lumbar|lumbar curve]] being larger than the thoracic one
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
*Type 2: an S shape deformity, in which both curves are structural and cross the CSVL, with the [[Thoracic|thoracic curve]] being larger or equal to the [[lumbar]] one
*Type 3: major [[thoracic]] curve in which only the thoracic curve is structural and crosses the CSVL
*Type 4: long C shape thoracic curve in which the fifth [[lumbar]] vertebra is centered over the [[sacrum]] and the fourth [[lumbar]] vertebra is tilted into the thoracic curve
*Type 5: double [[thoracic]] curve


OR
=== Neuromuscular Scoliosis ===
 
*Neuromuscular scoliosis can be further subdivided based on the classification of scoliosis research society.<ref name="McCarthy1999">{{cite journal|last1=McCarthy|first1=Richard E.|title=MANAGEMENT OF NEUROMUSCULAR SCOLIOSIS|journal=Orthopedic Clinics of North America|volume=30|issue=3|year=1999|pages=435–449|issn=00305898|doi=10.1016/S0030-5898(05)70096-1}}</ref>
The staging of [malignancy name] is based on the [staging system].
**Primary neuropathies
 
**Upper motor neuron neuropathies
OR
***[[Cerebral palsy]]
 
***Spinocerebellar degeneration
There is no established system for the staging of [malignancy name].
****[[Friedreich's ataxia|Friedreich ataxia]]
 
****[[Roussy-Levy disease]]
==Classification==
****[[Spinocerebellar ataxia]]
 
***[[Syringomyelia]]
*There is no established system for the classification of [disease name].
***[[Spinal cord tumor]]
OR
***[[Spinal cord trauma]]
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
**Lower motor neuron neuropathies
**[Group1]
***[[Poliomyelitis]]
**[Group2]
***Other viral myelitides
**[Group3]
***Traumatic
**[Group4]
***[[Charcot-Marie-Tooth disease]]
OR
***Spinal muscular atrophy
*[Disease name] may be classified into [large number > 6] subtypes based on:
**** [[Werdnig-Hoffmann disease]] (SMA type 1)
**[Classification method 1]
**** [[Kugelberg-Welander disease]] (SMA type 2)
**[Classification method 2]
***Dysautonomia
**[Classification method 3]
**** [[Riley-Day syndrome]]
*[Disease name] may be classified into several subtypes based on:
***Combined upper and lower pathologies
**[Classification method 1]
**** [[Amyotrophic lateral sclerosis]]
**[Classification method 2]
**** [[Myelomeningocele]]
**[Classification method 3]
**** Tether cord
OR
**Primary myopathies
*Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
***Muscular dystrophy
OR
**** [[Duchenne muscular dystrophy]]
*If the staging system involves specific and characteristic findings and features:
**** Limb-girdle dystrophy
*According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
**** Facioscapulohumeral dystrophy
OR
***[[Arthrogryposis]]
*The staging of [malignancy name] is based on the [staging system].
***Congenital [[hypotonia]]
OR
***Myotonia dystrophica
*There is no established system for the staging of [malignancy name].


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
 
{{WS}}
[[Category: (Orthopedics)]]
[[Category: (name of the system)]]

Latest revision as of 15:13, 10 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Classification

Scoliosis can be classified into congenital scoliosis (due to failure of vertebral formation or segmentation of affected vertebrae), idiopathic scoliosis(when the cause is not known) or neuromuscular scoliosis (due to loss of muscle strength or voluntary muscle control).

Congenital Scoliosis

Right supernumerary D10/D11 hemivertebra is noted associated with mild right dorsal scoliosis as well as mild focal kyphotic deformity. Case courtesy of Dr Mohammad A. ElBeialy, Radiopaedia.org, rID: 41542
Based on radiological finding
Complete failure - hemivertebra, butterfly vertebra
Failure of formation Partial failure - wedged vertebra
Unilateral failure - longitudinal failure
Failure of segmentation Bilateral failure - block vertebra
Miscellaneous Formation and segmentation mixed failure
Based on formation of error and the structural combining of the anterior and posterior vertebral component
Anterior component Posterior component
Hemivertebra (hemipedicle) Fully segmented hemilamina
Semisegmented hemilamina
Spina bifida
Bilamina (complete or incomplete)
Butterfly lamina (bipedicle) Wedged lamina
Spina bifida
Lateral wedged vertebra (bipedicle) Wedged Lamina
Based on 3-D CT
Type 1 Solitary simple congenital malformation (unison)
  • Hemivertebra
  • Wedged vertebra
  • Butterfly vertebra
  • Others
Type 2 Multiple simple anomalies (unison)
  • Combination of hemivertebra, wedged vertebra and butterfly vertebra
  • Discreet, adjacent or others
Type 3 Complex anomalies (discordant)
  • Mixed failure
Type 4 Segmentation failure only

Idiopathic Scoliosis

Idiopathic Thoracolumbar scoliosis. Source: Case courtesy by: Dr. Rohan A. Bhimani
Based on Age of Onset
Based on Anatomical Level Involved

King and Moe defined five curve types:

  • Type 1: an S shape deformity, in which both curves are structural and cross the CSVL, with the lumbar curve being larger than the thoracic one
  • Type 2: an S shape deformity, in which both curves are structural and cross the CSVL, with the thoracic curve being larger or equal to the lumbar one
  • Type 3: major thoracic curve in which only the thoracic curve is structural and crosses the CSVL
  • Type 4: long C shape thoracic curve in which the fifth lumbar vertebra is centered over the sacrum and the fourth lumbar vertebra is tilted into the thoracic curve
  • Type 5: double thoracic curve

Neuromuscular Scoliosis

References

  1. ↑ Winter RB, Moe JH (1960,Jan 01). "Congenital Scoliosis A Study of 234 Patients Treated and Untreated Part I: Natural History". J Bone Joint Surg Am. 50 (1): 1-15. Check date values in: |date= (help)
  2. ↑ Imagama S, Kawakami N (2005). "Spatial relationships between a deformed vertebra and an adjacent vertebra in congenial scoliosis-failure of formation". J Jpn Scoliosis Soc. 20: 20–25.
  3. ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.
  4. ↑ King HA, Moe JH, Bradford DS, Winter RB (1983). "The selection of fusion levels in thoracic idiopathic scoliosis". J Bone Joint Surg Am. 65 (9): 1302–13. PMID 6654943.
  5. ↑ McCarthy, Richard E. (1999). "MANAGEMENT OF NEUROMUSCULAR SCOLIOSIS". Orthopedic Clinics of North America. 30 (3): 435–449. doi:10.1016/S0030-5898(05)70096-1. ISSN 0030-5898.
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