🦴 Section 720.1 · Idiopathic Scoliosis

Nelson Textbook of Pediatrics 22nd Edition | Idiopathic scoliosis: spinal curvature ≥10° in coronal plane with vertebral rotation. Adolescent idiopathic scoliosis (AIS) — most common (10-18 years), female predominance. Early-onset scoliosis (EOS) — age <10 years (infantile <3y, juvenile 4-9y). Treatment: Cobb 10-25° → observe; 25-45° → brace (Boston, 18h/day); >45-50° → surgery (posterior spinal fusion). Bracing proven effective (BrAIST study). Growing rods (VEPTR, MCGR) for EOS. Anterior vertebral body tethering (fusionless) emerging.

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📋 30 Clinical Scenarios — Idiopathic Scoliosis

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🩺 Clinical Recognition: Idiopathic Scoliosis

Select a presentation to review diagnostic clues and management per Nelson 720.1.

📋 Stepwise Management of Idiopathic Scoliosis

🔑 Key Principles — Nelson Section 720.1
• Cobb angle: Standard measurement on standing PA radiograph.
• AIS treatment algorithm: Cobb 10-25° → observe (q6-12m). 25-45° → brace (Boston, 18h/day). >45-50° → surgery (posterior spinal fusion).
• Bracing efficacy: BrAIST study: 72% success vs 48% observation (prevent progression to 50°).
• Early-onset scoliosis: Mehta casting (infantile). Growing rods (VEPTR, magnetic MCGR) for progressive curves.
• Risser sign: Iliac crest ossification (0-5) — skeletal maturity.
• Left thoracic curve: MRI indicated to rule out intraspinal anomaly.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Idiopathic Scoliosis (Nelson 720.1)