Treatment Options for Scoliosis


        (based on classification of King et al)
                                                                           assistance provided by Ben Allen Jr. M.D.
- See: Selection of Fusion Level:

- King Type I:
    - S shaped or double curve with the lumbar curve larger and stiffer than the thoracic curve;
    - this type of curve is usually fuse down to L4 (via a posterior approach) or down
            to L3 (anterior approach);

- King Type II:
    - double curve in which the thoracic curve is larger and stiffer than the lumbar;
    - note that type II curves may be confused with a type III curve, but in the type II
           lumbar curve should not cross the midline;
    - often a thoracic fusion will suffice for these patients (or down to L1);
    - type II curves may also be confused with doulble major curves;
           - this confusion may occur when there is a thoracolumbar kyphosis in the saggital plane,
                  in which case fusion of both curves may be appropriate;
             

- King Type III:
    - single thoracic curve w/ no compensatory lumbar curve which crosses the midline;
    - managed w/ a thoracic fusion;

- King IV:
    - long thoracic curve in which the L4 tilts to thoracic curve;
    - fuse thru L4;

- King V:
    - double thoracic curve;
    - T1 tilts to upper curve;
    - fuse thru T2;
           - do not assume that the upper (left) thoracic curve is non-structural without proof, and if
                   there is any question, fuse the upper thoracic spine as well as the lower thoracic spine




The selection of fusion levels in thoracic idiopathic scoliosis.

Intraobersever and interobserver reliability of the classification of thoracic adolescent idiopathic scoliosis.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, April 24, 2012 4:45 pm