Teaching Points
- The primary imaging modality for evaluating adolescent scoliosis is a single PA erect film of the entire spine and including the iliac crests. A lateral film may also be performed.
- Scoliosis is present when there is a >10° abnormal lateral curvature of the spine in the coronal plane as defined by the Cobb angle.
- MRI is indicated for detection of spinal cord abnormalities when one or more “red flag” features are present.
- The role of MRI for imaging all patients prior to surgical correction remains controversial. Recent studies indicate MRI is not required in preoperative patients with a negative history, normal physical examination and a typical curve pattern.
- Prior to surgery, passive lateral bending plain films in the frontal plane enables the surgeon to measure the degree of correction and determine the levels included in the operation.
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