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Current concepts and controversies on adolescent idiopathic scoliosis: Part I

Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformiti...

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Autores principales: Sud, Alok, Tsirikos, Athanasios I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654460/
https://www.ncbi.nlm.nih.gov/pubmed/23682172
http://dx.doi.org/10.4103/0019-5413.108875
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author Sud, Alok
Tsirikos, Athanasios I
author_facet Sud, Alok
Tsirikos, Athanasios I
author_sort Sud, Alok
collection PubMed
description Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformities which affect the coronal and sagittal planes, as well as the rib cage, waistline symmetry, and shoulder balance. Patient's dissatisfaction in terms of physical appearance and mechanical back pain, as well as the risk for curve deterioration are usually the reasons for treatment. Conservative management involves mainly bracing with the aim to stop or slow down scoliosis progression during growth and if possible prevent the need for surgical treatment. This is mainly indicated in young compliant patients with a large amount of remaining growth and progressive curvatures. Scoliosis correction is indicated for severe or progressive curves which produce significant cosmetic deformity, muscular pain, and patient discontent. Posterior spinal arthrodesis with Harrington instrumentation and bone grafting was the first attempt to correct the coronal deformity and replace in situ fusion. This was associated with high pseudarthrosis rates, need for postoperative immobilization, and flattening of sagittal spinal contour. Segmental correction techniques were introduced along with the Luque rods, Harri-Luque, and Wisconsin systems. Correction in both coronal and sagittal planes was not satisfactory and high rates of nonunion persisted until Cotrel and Dubousset introduced the concept of global spinal derotation. Development of pedicle screws provided a powerful tool to correct three-dimensional vertebral deformity and opened a new era in the treatment of scoliosis.
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spelling pubmed-36544602013-05-16 Current concepts and controversies on adolescent idiopathic scoliosis: Part I Sud, Alok Tsirikos, Athanasios I Indian J Orthop Review Article Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformities which affect the coronal and sagittal planes, as well as the rib cage, waistline symmetry, and shoulder balance. Patient's dissatisfaction in terms of physical appearance and mechanical back pain, as well as the risk for curve deterioration are usually the reasons for treatment. Conservative management involves mainly bracing with the aim to stop or slow down scoliosis progression during growth and if possible prevent the need for surgical treatment. This is mainly indicated in young compliant patients with a large amount of remaining growth and progressive curvatures. Scoliosis correction is indicated for severe or progressive curves which produce significant cosmetic deformity, muscular pain, and patient discontent. Posterior spinal arthrodesis with Harrington instrumentation and bone grafting was the first attempt to correct the coronal deformity and replace in situ fusion. This was associated with high pseudarthrosis rates, need for postoperative immobilization, and flattening of sagittal spinal contour. Segmental correction techniques were introduced along with the Luque rods, Harri-Luque, and Wisconsin systems. Correction in both coronal and sagittal planes was not satisfactory and high rates of nonunion persisted until Cotrel and Dubousset introduced the concept of global spinal derotation. Development of pedicle screws provided a powerful tool to correct three-dimensional vertebral deformity and opened a new era in the treatment of scoliosis. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3654460/ /pubmed/23682172 http://dx.doi.org/10.4103/0019-5413.108875 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Sud, Alok
Tsirikos, Athanasios I
Current concepts and controversies on adolescent idiopathic scoliosis: Part I
title Current concepts and controversies on adolescent idiopathic scoliosis: Part I
title_full Current concepts and controversies on adolescent idiopathic scoliosis: Part I
title_fullStr Current concepts and controversies on adolescent idiopathic scoliosis: Part I
title_full_unstemmed Current concepts and controversies on adolescent idiopathic scoliosis: Part I
title_short Current concepts and controversies on adolescent idiopathic scoliosis: Part I
title_sort current concepts and controversies on adolescent idiopathic scoliosis: part i
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654460/
https://www.ncbi.nlm.nih.gov/pubmed/23682172
http://dx.doi.org/10.4103/0019-5413.108875
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