Scoliose idiopathique. Stratégie diagnostique, physiopathologie et analyse de la déformation

Abstract

Idiopathic scoliosis has no detectable cause and occurs in previously healthy children. The spinal curvature produces a deformity in the three planes resulting in vertebral rotation with a rib-hump and alteration of the sagittal balance of the trunk. The diagnosis of scoliosis is readily made by asking the patient to bend forward: presence of thoracic asymmetry in this position indicates scoliosis and rules out less worrisome causes of spinal curvature. The scoliotic curvature may worsen, the risk being greatest during the growth period. The pubertal growth spurt may be accompanied with rapid development of a severe deformity. This is often the case in patients with scoliosis since early childhood. Every patient with scoliosis should receive careful follow-up at 6-month intervals until growth completion.