KnotesFree Orthopaedic & FRCS notes, viva stations and higher order SBAs

King scoliosis

High YieldSpinethinKbox SBA

Overview

The King classification is a historical classification for adolescent idiopathic scoliosis based primarily on coronal curve pattern. It was developed to guide selection of fusion levels in posterior surgery and has largely been superseded by the Lenke classification.

Type I

  • Double curve
  • Both thoracic and lumbar curves cross the midline
  • Lumbar curve is larger and less flexible than the thoracic curve

Type II

  • Double curve
  • Both curves cross the midline
  • Thoracic curve is larger and less flexible than the lumbar curve

Type III

  • Thoracic curve crosses the midline
  • Lumbar curve does not cross the midline

Type IV

  • Long thoracic curve
  • L5 is centred over the sacrum
  • L4 tilts into the thoracic curve

Type V

  • Double thoracic curve pattern
  • Upper thoracic structural component with T1 tilt

Limitations

The classification has limited reliability and does not adequately describe sagittal alignment, lumbar modifiers or many modern three-dimensional considerations. Lenke classification is preferred for contemporary surgical planning.

References

  1. Orthobullets. King Classification of AIS.

Written/reviewed by Kishore Puthezhath

Professor of Orthopaedics and Consultant Paediatric Orthopaedic Surgeon

FRCS (Tr & Orth) revision resource

Reviewed: September 2026