Presentation
Recent neck pain. Known history of adolescent idiopathic scoliosis.
Patient Data
Scoliosis with a primary lumbar curvature to the left (24.44°) and a secondary thoracic curvature to the right (13.56°). No pelvic obliquity.
(See image below for angle measurements)
Case Discussion
Scoliosis is commonly referred to as the lateral deviation of the spine. Although this is correct, the actual deformity isn't limited to the coronal plane, there is a rotational component as well, making the true curvature three-dimensional.
Idiopathic scoliosis is the most common form of the condition, which can be further classified regarding the age of onset, with adolescent idiopathic scoliosis being the most common subtype (between 10 years of age and skeletal maturity).
Measuring the curvatures is essential in the evaluation of a scoliotic patient. The method of Cobb is the recommended technique. To measure the curve:
determine the superior and inferior end vertebrae
draw a line tangential to the superior end plate or pedicles of the superior end vertebra
draw a line tangential to the inferior end plate or pedicles of the inferior end vertebra
if the lines intersect, measure the angle between the; if they do not intersect inside the image, draw lines perpendicular to the previous ones and measure the angle between them
The end vertebrae are those most tilted toward the concavity.
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