Triple Major Curves in Children

· (a – Division of Pediatric Orthopaedics, Children’s Hospital of Eastern Ontario)

The predominant classification systems for scoliosis have either been based upon etiology or curve pattern. Triple curves have not been traditionally included in either classification system until the recent classification proposed by Lenke et al (5). We reviewed our experience with this curve pattern at a major pediatric referral center. Fifteen children have been treated for a triple scoliosis curve. There were eleven girls and four boys. The average age at the time of initial presentation was eleven years and ten months, ranging from six years and eleven months to fifteen years and six months. The average length of follow-up was three years and nine months, ranging between one year and eleven years. The most progressive curve was the middle curve with the lower curve being the least. Three children have required spinal fusion if the proximal two curves. The lumbar curve should be included in the fusion if it is greater than 40 degrees and does not correct on lateral bending films. Of these children, at the time of most recent follow-up, the curve was stable and good fusion was attained. Of the remaining children, two were treated with an orthosis and ten are being observed. The triple major curve is a neglected curve pattern that should be included in classifications of scoliosis.

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