Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification.
- 3D spine measurement – provides information about anatomical changes of the back and spine without radiation exposure. It captures the interrelationships of the spine, pelvis and back, providing an accurate picture of body statics.
- Fetal sonography (ultrasound examination of the unborn child) – if scoliosis of the unborn child is suspected.
- X-ray spine (whole spine radiography) under standardized conditions in standing position in 2 planes (sagittal and frontal projection planes) – can be performed in case of progression of scoliosis or for control; X-ray diagnostics for preoperative planning:
- Determination of the extent of flexibility (bending capacity) → side-bending radiograph (bending radiograph) under standardized conditions.
- For each major curvature present, left and right bending should be performed.
- Presence of hyperkyphosis (“hunchback“) → lateral hyperextension recording (recording in strong extension) in the supine position as a so-called hypomochlion recording (should be applied to the vertex) or a traction recording, with the patient in the supine position.
- Magnetic resonance imaging (MRI) – preoperatively, if intraspinal (“inside the spinal canal“) disease is suspected (“tethered cord”, diastematomyelia, syringomyelia) or to avoid overlooking malformations of the spinal cord.
- Computed tomography (CT) of the spine in the area of the planned instrumentation route – to differentiate bony diseases and to determine rotation; preoperatively to determine the diameter or length of the screws based on the anatomical conditions.
- Skeletal maturity determination to assess bone age [determination of residual spinal growth as a function of Risser stage].
- Spirometry (pulmonary function testing) – to detect possible pulmonary restrictions (restrictive ventilation disorders) in scoliosis and kyphosis from an angle of > 70° according to Cobb.
- Gait analysis (3-D gait analysis), to show disorders of spinopelvic balance with misrotation of the pelvis – in cases of 4-arch and lumbar scoliosis.
The diagnosis of scoliosis is made by X-ray. The degree of scoliosis is indicated with the help of the Cobb angle (= degree of curvature; represents the curvature of the spine in a scoliosis in the frontal plane; measurement is made with goniometer or inclinometer on the X-ray). A Cobb angle greater than 10% is considered pathological (pathological).
Control examinations: Adolescent scolioses that are less than 20 degrees are clinically checked at 4- to 6-month intervals. If an increase in scoliosis is suspected, radiologic follow-up is performed.
