AORN Journal
Volume 90, Issue 3 , Pages 347-380 , September 2009

Infantile and Juvenile Scoliosis: The Crooked Path to Diagnosis and Treatment

  • Jane Maureen Wick, RN, BSN

      Affiliations

    • Jane Maureen Wick, RN, BSN, is a surgical staff nurse at Shriners Hospital, Portland, OR. Ms Wick has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.
    • ,
  • Julie Konze, RN, BSN

      Affiliations

    • Julie Konze, RN, BSN, is the surgical services charge nurse at Shriners Hospital, Portland, OR. Ms Konze has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.
    • ,
  • Kelly Alexander, RN, BSN

      Affiliations

    • Kelly Alexander, RN, BSN, is a care coordination nurse at Shriners Hospital, Portland, OR. Ms Alexander has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.
    • ,
  • Chris Sweeney, RN, ADN

      Affiliations

    • Chris Sweeney, RN, ADN, is a care coordination nurse at Shriners Hospital, Portland, OR. Ms Sweeney has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

  • Image Result

    X-ray of a girl with juvenile idiopathic scoliosis in which the curve is right-sided.

    X-ray of a girl with juvenile idiopathic scoliosis in which the curve is right-sided.

  • Image Result

    A computed tomography scan showing a child with combined failures of segmentation and formation.

    A computed tomography scan showing a child with combined failures of segmentation and formation.

  • Image Result

    A three-dimensional computed tomography scan showing a lateral view of hemivertebra with resulting spine angulation.

    A three-dimensional computed tomography scan showing a lateral view of hemivertebra with resulting spine angulation.

  • Image Result

    A three-dimensional computed tomography scan showing a posterior view of hemivertebra with bone fusion.

    A three-dimensional computed tomography scan showing a posterior view of hemivertebra with bone fusion.

  • Image Result

    Cobb angle measured on an x-ray of a patient with nonstructural scoliosis related to a syrinx.

    Cobb angle measured on an x-ray of a patient with nonstructural scoliosis related to a syrinx.

  • Image Result

    X-ray of a patient with infantile scoliosis without a brace.

    X-ray of a patient with infantile scoliosis without a brace.

  • Image Result

    X-ray of the same patient with the curves controlled by a brace.

    X-ray of the same patient with the curves controlled by a brace.

  • Image Result

    Sample braces (back row, from left) Milwaukee brace with mandibular extension; Providence brace for a double curve; Boston brace for a left-thoracic/right-lumbar curve; and Boston brace for a right-th

    Sample braces (back row, from left) Milwaukee brace with mandibular extension; Providence brace for a double curve; Boston brace for a left-thoracic/right-lumbar curve; and Boston brace for a right-thoracic/left-lumbar curve. (Front row, from left) posterior view of a Boston brace; posterior view of a soft Boston brace; low-profile, corrective kyphosis brace; and Providence brace for a lumbar curve.

  • Image Result
    Pediatric body casting table designed and built by Rob Eldridge, a registered technician in prosthetics and orthotics at Shriners Hospital, Portland, OR.

    Pediatric body casting table designed and built by Rob Eldridge, a registered technician in prosthetics and orthotics at Shriners Hospital, Portland, OR.

  • Image Result
    Charles d'Amato, MD, FRCSC, pediatric orthopedic spine surgeon, applies a body cast with traction while the patient is under general anesthesia.

    Charles d'Amato, MD, FRCSC, pediatric orthopedic spine surgeon, applies a body cast with traction while the patient is under general anesthesia.

  • Image Result
    Completed body cast with abdominal hole for abdominal expansion.

    Completed body cast with abdominal hole for abdominal expansion.

  • Image Result
    Circle-electric bed for halo traction.

    Circle-electric bed for halo traction.

  • Image Result
    Tricycle adapted for halo traction.

    Tricycle adapted for halo traction.

  • Image Result
    Four-point walker adapted for halo traction.

    Four-point walker adapted for halo traction.

  • Image Result
    Standard wheelchair adapted for halo traction.

    Standard wheelchair adapted for halo traction.

  • Image Result
    Congenital scoliosis demonstrating fusion from the thoracolumbar junction to the sacrum. Thoracic insufficiency syndrome is related to abdominal crowding/displacement.

    Congenital scoliosis demonstrating fusion from the thoracolumbar junction to the sacrum. Thoracic insufficiency syndrome is related to abdominal crowding/displacement.

  • Image Result
    Postoperative x-ray of a patient with cat eye syndrome who underwent rib-to-spine vertical expandable prosthetic titanium rib implantation.

    Postoperative x-ray of a patient with cat eye syndrome who underwent rib-to-spine vertical expandable prosthetic titanium rib implantation.

  • Image Result
    Postoperative x-ray of a patient with arthrogryposis who underwent bilateral rib-to-pelvis vertical expandable prosthetic titanium rib implantation.

    Postoperative x-ray of a patient with arthrogryposis who underwent bilateral rib-to-pelvis vertical expandable prosthetic titanium rib implantation.

  • Image Result
    Postoperative x-ray of a patient who underwent bilateral rib-to-rib and bilateral rib-to-pelvis vertical expandable prosthetic titanium rib implantation.

    Postoperative x-ray of a patient who underwent bilateral rib-to-rib and bilateral rib-to-pelvis vertical expandable prosthetic titanium rib implantation.

  • Image Result
    Before serial casting and halo traction.

    Before serial casting and halo traction.

  • Image Result
    After serial casting and halo traction.

    After serial casting and halo traction.

  • Image Result
    Before traction and instrumentation.

    Before traction and instrumentation.

  • Image Result
    After traction and instrumentation.

    After traction and instrumentation.

  • Image Result
    Before vertical expandable prosthetic titanium rib implantation.

    Before vertical expandable prosthetic titanium rib implantation.

  • Image Result
    After vertical expandable prosthetic titanium rib implantation.

    After vertical expandable prosthetic titanium rib implantation.

 New! Complete this CE activity online at aorn.org/CE indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 377–378 and then completing the answer sheet and learner evaluation on pages 379–380. The contact hours for this article expire September 30, 2012.This article is also approved for 7.2 (S) Category I credits by the American Board for Certification in Orthotics, Prosthetics, and Pedorthics for the following programs: orthotists, orthotic assistants, and orthotic technicians.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN recognizes these activities as continuing education for registered nurses. This recognition does not imply that AORN or the American Nurses Credentialing Center approves or endorses products mentioned in the activity.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.Editor's note: VEPTR is a trademark of Synthes Spine Company, West Chester, PA.

PII: S0001-2092(09)00551-1

doi: 10.1016/j.aorn.2009.06.019

AORN Journal
Volume 90, Issue 3 , Pages 347-380 , September 2009

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