Adoleszente idiopathische Skoliosen – Klassifikationen

Der Beitrag diskutiert die Möglichkeiten der Skolioseklassifikation. Die idiopathische Adoleszentenskoliose wird heutzutage nach Lenke klassifiziert. Die Lenke-Klassifikation bietet entscheidende Vorteile gegenüber der King-Klassifikation, die jedoch in der konservativen Skoliosetherapie noch Bedeutung hat. Zur Operationsplanung sind die Lenke-Klassifikation und das klinische Bild zusammen entscheidend.

Abstract

Still, the etiology of idiopathic scoliosis remains unclear, although a familial disposition exists. The classification according to Lenke is the most commonly used system. In conservative scoliosis therapy, the King classification is still important. Conservative therapy is indicated for a Cobb angle between 20° and 40° until the physical growth is complete. Surgery should be considerend for Cobb angles of 40° or 50° regardless of the patient’s age. Scoliosis surgery requires intensive planning within clear guidelines. The Lenke classification plays a decisive role.

Schlüsselwörter

Cobb-Winkel - Wirbelsäulenverkrümmung - Wirbelsäulenchirurgie - Wirbelsäulendeformität

Keywords

Cobb angle - spinal curvature - spinal surgery - spinal deformity

Publication History

Received: 08 November 2020

Article published online:
03 November 2021

• Literatur

• 1 Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent scoliosis. J Child Orthop 2013; 7: 3-9 DOI: 10.1007/s11832-012-0457-4. (PMID: 24432052)
• 2 Dayer R, Haumont T, Belaieff W. et al. Idiopathic scoliosis: etiological concepts and hypotheses. J Child Orthop 2013; 7: 11-16 DOI: 10.1007/s11832-012-0458-3. (PMID: 24432053)
• 3 Nachemson A, Lonstein J, Weinstein S. Report of the Scoliosis Research Society Prevalence and Natural History Committee 1982. www.svs.org
• 4 Weinstein S, Ponseti I. Curve progression in idiopathic scoliosis: Long-term follow-up and prognosis in untreated patients. J Bone Joint Surg 1983; 65-A: 447-453
• 5 Weinstein SL, Dolan LA, Spratt KF. et al. Health and function of patients with untreated idiopathic scoliosis. JAMA 2003; 289: 559-67 DOI: 10.1001/jama.289.5.559. (PMID: 12578488)
• 6 King HA, Moe JH, Bradford DS. et al. The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am 1983; 65: 1302-1313
• 7 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; 83: 1169-1181 (PMID: 11507125)
• 8 Lenke LG, Betz RR, Heher TR. et al. Multisurgeon assesment of surgical decision-making in adolescent idiopathic scoliosis: Curve classification, operative approach, and fusion levels. Spine 2001; 26: 2347-2353
• 9 Liljenqvist U, Lerner T, Bullmann V. Selektive Fusionsmöglichkeiten der idiopathischen Skoliose unter kritischer Würdigung der Lenke Klassifikation. Orthopäde 2009; 38: 189-192
• 10 Schulte TL, Liljenqvist U, Hierholzer E. et al. Spontaneous correction and derotation of secondary curves after selective anterior fusion of idiopathic scoliosis. Spine 2006; 31: 315-321 DOI: 10.1097/01.brs.0000197409.03396.24. (PMID: 16449905)
• 11 Bergoin M, Gennari JM, Tallet JM. Taking the shoulders and pelvis into account in the preoperative classification of idiopathic scoliosis in adolescent and young adults (a constructive critique of Kings’s and Lenke’s system of classification). Eur Spine J 2011; 20: 1780-1787
• 12 Sangole AP, Aubin CE, Labelle H. et al. Three-dimensional classification of thoracic scoliosic curves. Spine 2009; 34: 91-99 DOI: 10.1097/BRS.0b013e3181877bbb. (PMID: 19127167)
• 13 Flynn JM, Betz RR, OʼBrien MF. et al. Radiographic classification of complications of instrumentation in adolescent idiopathic scoliosis. Clin Orthop Relat Res 2010; 469: 665-669
• 14 Thompson RM, Hubbard EW, Jo CH. et al. Brace success is related to curve type in patients with adolescent idiopathic scoliosis. J Bone Joint Surg Am 2017; 99: 923-928 DOI: 10.2106/JBJS.16.01050. (PMID: 28590377)
• 15 Liljenqvist U, Halm H, Bullmann V. Spontaneous lumbar curve correction in selective anterior instrumentation and fusion of idiopathic thoracic scoliosis of Lenke type C. Eur Spine J 2013; 22: S138-148 DOI: 10.1007/s00586-012-2299-7. (PMID: 22531898)