Chapman Explained

PREPARED BY
DR. MAJID AL-HOMIEDAN

Chapman Explained Dr. Majid Al-Homiedan

 Scoliosis

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan
 Infantile idiopathic scoliosis
diagnosed before the age
of 4 years.
90% are thoracic and
concave to the right.
 More common in boys.
90% resolve
spontaneously.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Juvenile idiopathic scoliosis
diagnosed between 4 and
10 years.
 More common in girls.
Almost always
progressive.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Adolescent idiopathic scoliosis
diagnosed between 10
years and maturity.
More common in
females.
Majority are concave to
the left in the thoracic
region.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Failure of formation and Scoliosis
 Incarcerated hemivertebra.
A straight spine with little
tendency to progression.
 B. Free hemivertebra. May
be progressive.
 C. Wedge vertebra. Better
prognosis than a free
hemivertebra.
 D. Multiple hemivertebrae.
Failure of formation on the
same side results in a
severe curve.
 . E. Central defect.
Butterfly vertebra

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Failure of Segmentation and Scoliosis
A. Bilateral block
vertebra and a short
spine, e.g. Klippel-Feil.
 B. Unilateral
unsegmented bar.
Severely progressive
curve with varying
degrees of kyphosis or
lordosis depending on
the position of the bar

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Mixed defects and Scoliosis
Unilateral unsegmented
bar and a hemivertebra.
Severely progressive.
 Partially segmented
incarcerated hemi-
vertebra.
 Bilateral failure of
segmentation
Incorporating a hemi-
vertebra

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Myelomeningocele and scoliosis
Linked to neurological
impairment.
Growth potential.
Other vertebral
anomalies.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Spinal Muscular Dystrophy and Scoliosis

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Friedreich’s Ataxia and scoliosis
About 2/3 of patients
with FA develop scoliosis
mainly due to muscle
weakness.
there’s speculation that
frataxin gene deficiency
might have direct effects
on bone development.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Poliomyelitis and Scoliosis
Viral invasion of motor
neurons leading to
wallerian
degeneration,muscle
weakness and eventually
scoliosis.
Leg length discrepancy
and limping is also
another cause of
scoliosis.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Cerebral Palsy and Scoliosis
Whether flaccid or
spastic cerebral palsy
both cause scoliosis.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Muscular Dystrophies and Scoliosis
 Duchenne muscular dystrophy,
deficient gene that makes
dystrophin. leading to muscle
break-down and weakness.
 Becker muscular dystrophy
 Myotonic dystrophy.
 Limb-girdle muscular dystrophy
 Facioscapulohumeral muscular
dystrophy

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Neurofibromatosis and Scoliosis
 in up to 40% of patients
 short, sharply angulated curve
which involve only few vertebra
associated with:
- Neural foramina enlargement
- Rib penciling
- kyphosis
- Vertebral body scalloping
- Dural ectasia
- Soft tissue masses

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Marfan’s syndrome and scoliosis
 scoliosis in 40-60%.
Double structural curves
are typical.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Homocystinuria and Scoliosis
 Inherited disorder of the
metabolism of the amino
acid methionine.
 Multisystemic disorder of
the connective tissue,
muscles, CNS, and
cardiovascular system.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Scoliosis Post Radiotherapy
Wedged and hypoplastic
vertebrae ± unilateral
pelvic or rib hypoplasia

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Leg-length discrepancy and Scoliosis
A flexible lumbar curve,
convex to the side of the
shorter leg
 Disparity of iliac crest
level.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Osteoid Osteoma and Scoliosis
10% occur in the spine.
A lamina or pedicle at the
apex of the curve will be
sclerotic or over grown.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
 Osteoblastoma and Scoliosis
 The spine is involved in
about 50 percent of cases
and it usually arises in the
posterior elements.
 It typically causes dull
pain and may be
associated with scoliosis
or nerve compression.

Chapman Explained Dr. Majid Al-Homiedan

Chapman Explained Dr. Majid Al-Homiedan
Chapman Explained Dr. Majid Al-Homiedan