Resembles idiopathic scoliosis with equal right and left thoracic curves. Progression of curves with or without fusion is faster than idiopathic. Exact cause is unknown but believed to be secondary to either osteomalacia, local fibromas, endocrine abnormality or mesoderm dysplasia. Considered pathologic if greater than 49 degrees. Possibly secondary to collapse of apical dystrophic vertebrae with flexion force created by rotation with the scoliosis.
Kyphosis contributes more to paraplegia as a result of tension on cord with flexion.
This typically occurs in the upper thoracic region where the cord -canal ratio is most critical. All patients going to surgery or undergoing spinal manipulation need cervical X-rays. MRI or CT myelogram to evaluate for intra or extradural mass, menigeocele, dural ectasia. Autologous graft and halo. If previous laminectomy, do anterior and posterior fusion.