Developmental and congenital conditions

Scoliosis and poor posture in children and adolescents

Adolescent idiopathic scoliosis is a three-dimensional deformity of the spine with a Cobb angle of 10° or more and vertebral rotation. Structural scoliosis must be distinguished from poor posture and postural kyphosis, which correct with voluntary control.

The doctor screens with the Adams forward bend test and a scoliometer, orders an X-ray of the whole spine and assesses remaining growth by the Risser stage. Treatment depends on the size of the curve and the remaining growth: monitoring, scoliosis-specific exercises (Schroth, SEAS), a brace for curves of approximately 25 to 40° during growth, and referral for surgery for larger curves.

Scheuermann’s disease

A developmental disorder of endochondral ossification of the vertebral endplates in adolescence, with wedge-shaped vertebrae and rigid thoracic kyphosis. The doctor monitors progression, and treatment includes targeted exercises and, if needed, a brace.

Bertolotti’s syndrome

A lumbosacral transitional vertebra with a neoarthrosis between the transverse process and the sacrum, which overloads the adjacent segment and speeds up disc degeneration. It is a common and often unrecognised cause of low back pain in younger people, and it is treated with an image-guided infiltration of the neoarthrosis and a stabilisation programme.