Adolescent Idiopathic Scoliosis

Adolescent Idiopathic Scoliosis

A side curvature of the spine that typically occurs in adolescents during their growth spurt, adolescent idiopathic scoliosis (AIS) is most common in girls. The cause is unknown, but it’s believed that there’s some genetic disposition for its development and 3% to 5% of all adolescents will have this form of scoliosis, which can range from mild to severe.

Symptoms of AIS

The most common signs of adolescent idiopathic scoliosis are back pain, an abnormal gait, uneven hips or a discrepancy in leg length. Patients with AIS may have one shoulder that’s higher the other. There may also be some visible curving of the spine to one side or the other. Often, the first indicator that something is wrong is that the child’s clothes no longer seem to fit correctly, such as the pant hems being uneven.

Left untreated, adolescent idiopathic scoliosis can cause permanent, significant deformity and lead to psychological distress and physical disability. That’s because as the vertebrae rotates, the rib cage is affected, which can cause secondary problems in the lung and heart, including shortness of breath.

Diagnosis

Initially, your doctor will want to take a complete medical history, including a full physical and neurological exam. Diagnostic tests will also be ordered to determine the extent of the scoliosis. This will provide the doctor with a baseline understanding of the patient’s overall health so an effective course of treatment can be devised. Additional tests may be conducted to determine range of motion, reflexes, etc.

Treatment Options

Some cases of adolescent idiopathic scoliosis can be treated non-surgically. If the curve is small (less than 15 to 20 degrees), no specific treatment may be required. If the curve is greater (20 to 40 degrees), a brace may be employed to prevent the curve from getting worse.

While the brace may be uncomfortable, especially when it has to be worn 16 to 23 hours a day, the bracing is important to avoid surgery, which would be the other course of treatment. Your doctor may also recommend exercise to help the spine return to its correct position.

Curves greater than 40 degrees do not respond well to bracing and surgery may be the only course of treatment.

If surgery is required, it will involve surgical implants of rods, hooks, screws and wire. The goal of the surgery is to straighten and balance the spine over time, securing it in place so the progression doesn’t get worse as the skeletal structure matures. Surgery can’t cure scoliosis. It simply keeps the deformity from getting worse.

Surgical approaches vary, depending on the extent of the curvature and the patient’s individual situation. In the majority of cases, the best option is a posterior procedure. In extreme cases, an anterior (front) and posterior (back) approach is required when the curve is over 75% or 80%.