Home > BNSSG ICB > Development Area >

Scoliosis (Draft)

Checked: not set yet by Rob Adams Next Review: not set yet

Overview

Scoliosis is a term that is used when a patient's spine twists and curves to the side. Scoliosis can occur at any age, but most commonly it develops during early adolescence. This is a period of rapid growth when a child’s body starts to grow and becomes more adult (1,2).

The younger the child and the greater the curvature, the worse the prognosis, with the exception of infantile scoliosis. Referral should therefore not be delayed as timely bracing can help to improve outcomes.

Skeletal maturity is important, as scoliosis can progress during skeletal growth.

Once a deformity has proved to be progressive, surgical intervention will probably be necessary because orthotic treatment is less effective in these cases (3).

Who to Refer

All children with suspected scoliosis should be referred.

Red Flags

Scoliosis may develop as a result of a spinal tumour causing musculoskeletal dysfunction. If a child has bone pain or swelling or systemic red flags then refer via a USC/2WW pathway:

Children & Young People – USC (2WW)

Before Referral

Information to include in a referral:

Age of onset of scoliosis
Is there a suspected underlying syndrome, trauma or neuromuscular condition or is it idiopathic (80% are idiopathic)
Adam's forward bend test - Ask the patient to bend forwards. Note whether the curvature increases or lessens with this manoeuvre. A fixed scoliosis becomes more obvious on flexion.

Imaging

Do not request imaging in primary care. Referrals will be triaged by the orthopaedic team and appropriate x-rays arranged.

Referral

Please submit referrals for patients aged under 16 years to paediatric spinal surgery via eRS.

For patients aged 16 years and older please refer via ??????

Resources

(1) Scoliosis :: Royal National Orthopaedic Hospital

(2) Scoliosis - NHS

(3) Scoliosis and Kyphosis. Curvature of the spine; treatment

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.