4th Pediatric Infectious Diseases Conference
 
 
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Pedi Poll
Today's Poll
Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?
No, it should be used only after drug sensitivity report
Yes, under guidance of an infectious disease expert
SCOLIOSIS
Scoliosis
Dr A.Johari.
Consulting Pediatric Orthopedic
Consultant at Bombay Hospital ,
B.J.Wadia Children's Hospital ,
Children's Orthopedic Centre.



Q. What are types of scoliosis ?

A.The various types of scoliosis are:

  • Postural scoliosis: It is not accompanied by rotational deformity and is fully correctable on lateral bending and recumbency.

  • Functional scoliosis: It results form leg length discrepancy and has a convexity towards the depressed side of the pelvis. It resolves on correction of the limb length.

  • Structural scoliosis: It is not fully correctable on lateral bending or traction. It is of various types:

    • Idiopathic - the commonest type. According to the age of onset:

      • Infantile - before the age of 3 years.
      • Juvenile - between the age of 3 and 10 years.
      • Adolescent - after the age of 10 years.

    • Congenital - It results from defective unilateral segmentation or formation. This is often associated with absence or fusion of ribs.

    • Neuromuscular which may be

    • Neurofibromatosis

    • Mesenchymal disorders e.g. Arthrogryposis, Morquio's Syndrome, Marfan's Syndrome.

    • Traumatic

Q. What is the commonest cause of scoliosis ?

A.75% of the scoliosis are idiopathic.

Q. What is idiopathic scoliosis ?

A.Idiopathic scoliosis is one where the etiology is unknown, but, it is probably genetic and the mode of inheritance is complex. Routine evaluation of school children aged 10-14 years has shown an incidence of up to 12%. Smaller curves (up to 15 degrees) and at a younger age, the incidence is equal in males and females. Beyond the age of 10-11 years 80% of the significant curves are in females.

Q. What is Idiopathic Infantile Scoliosis ?

A.It represents 1% of the scoliosis. It is not associated with vertebral anomalies. Curves less than 37 degrees resolve spontaneously. Curves more than 37 degrees are known to progress and are often associated with plagiocephaly. These curves are treated by succession of plaster jackets till 3 years of age when a Milwaukee brace can be fitted. If curves are progressive inspite of bracing treatment in the form of fusion is performed.

Q. What is Idiopathic Juvenile Scoliosis ?

A.This represents 10% of scoliosis cases. It is more common in girls and right-sided curves are common. Treatment is required in curves of more than 25-30 degrees.

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