Evaluation and treatment of scoliosis

1. What is the Adams test?
2. What is the Cobb method?
3. When are PFTs done? What is the most common abnormality on PFTs?
4. What is the treatment for scoliosis based on the degree of curvature?
5. How much does curvature generally progress during adolescent growth?

Answers:
1. Have patient bend forward with legs straight at knees. Posterior trunk is prominent at convex side of curve.
2. On radiograph, draw line through superior endplate of apex of curve, then inferior endplate of bottom of curve, calculate angle.
3. If thoracic scoliosis is >50-60 deg, there may be PFT abnormalities. Most common is decreased VC.
4. 1-20 degrees: observe. 20-40 degrees: brace if idiopathic, surgery if neuromuscular. >40 deg: surgery.