On examination, the Adams forward bend test (a clinical test for assessing scoliosis) may be positive where a rib hump forms on the side of the convexity. In most instances, scoliosis is obvious if severe. The stable vertebra is the first vertebra below the lowest curve which is roughly bisected by the central sacral vertical line (CSVL). They are never closer to the apex than the end vertebrae 1. In some cases, they will be the same as the end vertebrae although usually, they will be few segments more distal to the apex. Neutral vertebrae are present on either side of the apex and are the vertebrae that demonstrate no rotation (axial plane). The end vertebrae are present on either side of the apex and are the vertebrae that are most tilted towards each other 1,4. The endplates of the apical vertebra are often horizontal or near horizontal. The apex is the vertebral body or disc space which demonstrates the greatest rotation and/or furthest deviation from the expected center of the vertebral column 1. Secondary curves, minor curves and non-structural curves usually all refer to the less pronounced compensatory curves that develop above and/or below the primary curve to maintain balance 1. The most pronounced curve is usually the one at which the main structural abnormality is present and thus in most patients the terms primary curve, major curve and structural curve are interchangeable 1. Levoscoliosis: curvature towards the leftĭextroscoliosis: curvature towards the right Naming curvesĮach curve of a scoliosis can be described in terms of the direction of convexity as Asymptomatic lateral curvature of the spine that is stable, with a Cobb angle ≤10° is known as spinal asymmetry 2. Early onset scoliosis refers to scoliosis with a onset 10°.
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