Bone Health

Wheeless' Textbook of Orthopaedics
Treatment based on King et al Algorithm - Discussion: - fusion mass needs to include distal vertebra of structural curve; - if a more distal vertebra appears rotated in the same direction as more cephalad vertebrae, it should be included in the fusion mass; - arthrodesis should include the first stable vertebra - this is the vertebrae that is bisceted by a line drawn thru the middle of the spinous process of S1 perpendicular to the iliac crest; - in low lumbar curves, avoid extending the fusion mass past L4;

Three-Dimensional Terminology of Spinal Deformity By the Scoliosis Research Society Working Group on 3-D terminology of spinal deformity (Chair Ian Stokes, PhD) Excerpted from: Stokes IAF (chair) Scoliosis Research Society Working Group on 3-d terminology of spinal deformity: Three-dimensional terminology of spinal deformity. Spine, 19: 236-248, 1994.

List of scoliosis references in subsections -
Prevalence & Natural History
Adult Scoliosis
Arthrogryposis
Cerebral Palsy
Congenital Scoliosis
Duchenne Muscular Dystrophy
Dwarfing Conditions
Ehlers-Danlos
Freidreich's Ataxia
Marfan's
Neurofibromatosis
Osteogenesis Imperfecta
Rett Syndrome
Spina Bifida
Spinal Muscular Atrophy
Miscellaneous

Glossary of Spinal Deformity Biomechanical Terms (Selected and adapted from Panjabi MM and White AA: Appendix: Glossary, in: Clinical Biomechanics of the Spine. (2nd Edition) by White AA and Panjabi MM, Philadelphia: J.B. Lippincott, 1990) Proposed by the SRS Terminology Committee, 1999
This short guide to terms in spinal biomechanics is divided into five sections:
Axis systems, etc.
Loading
Displacement and deformation
Load-deformation and stress-strain relations
Failure
Equilibrium Stability

SRS Terminology Committee and Working Group on Spinal Classification
Revised Glossary of Terms prepared by the Working Group on 3-D Classification (Chair Larry Lenke, MD), and the Terminology Committee, March 2000

Pwerpoint Presentation showing the technique of application of a Risser-Cotrel cast for Juvenile Scoliosis

Scoliosis Research Society White Paper on Sagittal Plane Alignment. Discussion of evaluation and correction of kyphosis and lordosis

Wheeless' Textbook of Orthopaedics
progression: - rt thoracic curves> 50 deg are at highest risk for progression (1 deg/yr) followed by Rt lumbar curves; - single thoracic curves> 70-75 deg at growth completion progress an average of about 17 deg; - high thoracic or cervicothoracic curves usually are of congenital etiology and rarely are idiopathic & often produce major deformity; - left thoracic scoliosis is rare, and evaluation of spinal cord by MRI, is performed to rule out cord abnormalities;

Wheeless' Textbook of Orthopaedics
Choices for Instrumentation: - Zielke Instrumentation: - used for treatment of rigid or mobile lumbar or thoracolumbar Scoliosis w/ lordosis; - CD instrumentation: - for patients who have a mobile lumbar or thoracolumbar curve; - may provide a permanent derotation & restoration of lordosis; - Indications for Surgery: - thoracolumbar or lumbar curves greater than 40 to 45 deg; - marked imbalance w/ shift to one side; - substantial pain; - progression of deformity;

Wheeless' Textbook of Orthopaedics
(based on classification of King et al)

There are many causes of scoliosis. There are too many to list and to fully discuss here. A number of unusual types of scoliosis are briefly outlined -

• Marfans
• Ehler’s-Danlos syndrome
• Neurofibromatosis
• Growth Conditions or Dysplasias

Wheeless' Textbook of Orthopaedics
used for rigid or mobile lumbar or thoracolumbar Scoliosis with lordosis