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Escoliose idiopática do adolescente

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  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 26 Nov 2025
Última atualização: 09 Mar 2022

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • idade >10 anos
  • 6 a 12 meses após a puberdade
  • assimetria postural
  • dor ausente ou mínima
  • ausência de sintomas neurológicos com exame neurológico normal
  • proeminências paraespinhais ao inclinar para frente
  • medição do escoliômetro >5° para proeminência paraespinhal
  • reflexos abdominais simétricos
Detalhes completos

Outros fatores diagnósticos

  • assimetria do ombro
  • assimetria na linha da cintura
  • assimetria da parede torácica ou de mama
  • reflexo faríngeo normal
  • descompensação do tronco
Detalhes completos

Fatores de risco

  • história familiar positiva
  • pico do estirão de crescimento em adolescentes
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • exame clínico
Detalhes completos

Investigações a serem consideradas

  • radiografias posteroanteriores em posição ortostática da coluna cervical, torácica, lombar e da pelve
  • radiografias laterais em posição ortostática da coluna cervical, torácica, lombar e da pelve
  • ressonância nuclear magnética (RNM) da coluna cervical, torácica, lombar e sacral, e do tronco encefálico
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

rastreamento por medição do escoliômetro de <5° ou medida do ângulo de Cobb coronal de ≤10°

medida do ângulo de Cobb coronal em posição ortostática de 11° a 20°

medida do ângulo de Cobb coronal em posição ortostática de 21° a 45°

medida do ângulo de Cobb coronal em posição ortostática de >45°

Colaboradores

Autores

Joshua M. Eisenberg, MD

Clinical Research Fellow

Department of Orthopaedics and Rehabilitation

University of Iowa Hospitals and Clinics

Iowa City

IA

Раскрытие информации

JME declares that he has no competing interests.

Stuart L. Weinstein, MD

Ignacio V. Ponseti Chair and Professor of Orthopaedics

Department of Orthopaedics and Rehabilitation

University of Iowa Hospitals and Clinics

Iowa City

IA

Раскрытие информации

SLW has received royalties from Wolters Kluwer for text book editing. SLW is a former board member of the Journal of Bone and Joint Surgery (ended in 2013); he was involved in a NIH RO1 research grant programme until 2015; and he is an author of several references cited in this topic.

Выражение благодарностей

Dr Stuart L. Weinstein and Dr Joshua M. Eisenberg would like to thank Dr Ryan M. Ilgenfritz, a previous contributor to this topic.

Раскрытие информации

RMI declared that he had no competing interests.

Рецензенты

John M. (Jack) Flynn, MD

Associate Chief of Orthopaedic Surgery

The Children's Hospital of Philadelphia

Philadelphia

PA

Раскрытие информации

JMF declares that he has no competing interests.

Amer Samdani, MD

Director

Pediatric Spine Surgery

Shriners Hospitals for Children

Philadelphia

PA

Раскрытие информации

AS is a paid consultant for Synthes Spine, Depuy Spine, and SpineVision.

Andre Tomasino, MD

Neurosurgeon

Department of Neurosurgery

Hospital Munich-Bogenhausen

Munich

Germany

Раскрытие информации

AT declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Parent S, Newton PO, Wenger DR. Adolescent idiopathic scoliosis: etiology, anatomy, natural history, and bracing. Instr Course Lect. 2005;54:529-36. Аннотация

Yaszay B, Newton PO. Idiopathic scoliosis. In: Weinstein SL, Flynn JM, Crawford HA, eds. Lovell and Winter's Pediatric Orthopaedics. 8th ed. Philadelphia: Wolters Kluwer, 2021:659-720.

Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001 Aug;83(8):1169-81. Аннотация

Cheng JC, Castelein RM, Chu WC, et al. Adolescent idiopathic scoliosis. Nat Rev Dis Primers. 2015 Sep 24;1:15030. Аннотация

Harrop JS, Birknes J, Shaffrey CI. Noninvasive measurement and screening techniques for spinal deformities. Neurosurgery. 2008 Sep;63(3 Suppl):46-53. Аннотация

Negrini S, Donzelli S, Aulisa AG, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.Полный текст  Аннотация

Yawn B, Yawn RA. Efficacy of school scoliosis screening. Orthopedics. 2001 Apr;24(4):317. Аннотация

Weinstein SL, Dolan LA, Spratt KF, et al. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003 Feb 5;289(5):559-67.Полный текст  Аннотация

Weinstein SL. Idiopathic scoliosis. Natural history. Spine. 1986 Oct;11(8):780-3. Аннотация

Dickson JH, Mirkovic S, Noble PC, et al. Results of operative treatment of idiopathic scoliosis in adults. J Bone Joint Surg Am. 1995 Apr;77(4):513-23. Аннотация

Betz RR, Harms J, Clements DH 3rd, et al. Comparison of anterior and posterior instrumentation for correction of adolescent thoracic idiopathic scoliosis. Spine. 1999 Feb 1;24(3):225-39. Аннотация

Danielsson AJ, Nachemson AL. Back pain and function 22 years after brace treatment for adolescent idiopathic scoliosis: a case-control study-part I. Spine (Phila Pa 1976). 2003 Sep 15;28(18):2078-85; discussion 2086. Аннотация

Edgar MA, Mehta MH. Long-term follow-up of fused and unfused idiopathic scoliosis. J Bone Joint Surg Br. 1988 Nov;70(5):712-6.Полный текст  Аннотация

Weinstein SL, Dolan LA, Cheng JC, et al. Adolescent idiopathic scoliosis. Lancet. 2008 May 3;371(9623):1527-37. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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