Scoliosis classification

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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
  • Congenital scoliosis is subdivided based on radiological finding, combined structural component involved and 3-D CT.[1][2]
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
  • Idiopathic scoliosis may be further classified into three types based on age of onset and anatomical level involved.[3]

Based on Age of Onset

  • Infantile idipathic scoliosis (birth to 3 years)
  • Juvenile idiopathic scoliosis (4 to 9 years)
  • Adolescent idiopathic scoliosis (10 to 20 years)

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 forth 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. 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.