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Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 143-150

Classification systems in adolescent idiopathic scoliosis revisited: Is a three-dimensional classification needed?

Department of Orthopaedics, Bharati Vidyapeeth Medical College, Pune, Maharashtra, India

Correspondence Address:
Krishnankutty Venugopal Menon
Department of Orthopaedics, Bharati Vidyapeeth Medical College, Pune, Maharashtra.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/isj.isj_74_19

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Classification systems for adolescent idiopathic scoliosis (AIS) have been in existence since the Schulthess system of 1905. Despite the numerous schema that have evolved over the last 115 years, little has changed from the original system based on the location of the coronal plane apex of the curves. Attempts at adding the sagittal plane, axial plane and shoulder balance to the system has generally yielded unscientific schemas or unwieldy numbers of variables within the scheme. The fundamental flaw with all these classifications is that they are based on two-dimensional imaging. The introduction of 3-D imaging like EOS and surface topography studies allow us an entirely novel perception of the spinal orientation in space. Thus the 3-D classifications that have emerged does not necessarily mean adding on Cartesian co-ordinates to the existing systems, but a far more comprehensive, yet simplistic view of the spinal deformity. Evidently, we are far from fully establishing all the variables and potentials of such schemas. Current modalities of 3-D imaging and evaluation are largely in the research domain and have not yet reached the clinical practice stage. The clinical utility of such 3-D classifications is also conjectural at present. But it is eminently possible that in the foreseeable future scoliosis classifications would cease to appear and be applied as they are today.

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