Idiopathic Scoliosis in Adolescents

Adolescent scoliosis is a kind of scoliosis that affects people between the ages of 10 and 18. It can be caused by a variety of factors. Idiopathic or adolescent idiopathic scoliosis is by far the most frequent kind of scoliosis in the adolescent years since the reason is unknown (AIS). Even though much study is continuing in this area, including the genetic foundation for AIS, there are yet no known reasons for this disorder. Despite this, we now have reliable ways for determining the risk of scoliosis curve advancement as well as effective treatment options.

Causes

Although substantial attempts are being made to determine the etiology of AIS, there are currently no well-accepted reasons for this kind of scoliosis. The great majority of people are in good health and have no medical history. Hormonal imbalance, asymmetric development, and muscular imbalance are some of the explanations for the etiology of AIS. There appears to be a genetic link between AIS and scoliosis since around 30% of AIS patients have a family history of scoliosis. Many members of the Scoliosis Research Society are striving to uncover the genes that cause AIS, and so this knowledge is rapidly expanding. Many genes are thought to be linked to scoliosis, and each one may be useful in identifying scoliosis and assessing the risk.

Symptoms

Pain and neurologic signs are uncommon in adolescent idiopathic scoliosis. The bend of the spine doesn't exert pressure on organs like the lungs or heart, thus AIS does not cause symptoms like shortness of breath. Patients with adolescent scoliosis may have back discomfort, usually in the lower back region. Even though it is frequently connected with scoliosis, it is usually believed that the curve does not cause discomfort. Adolescents suffer from low back discomfort regularly. Many teenagers suffer from back discomfort as a result of participating in a variety of sports without having adequate core abdominal or back strength and also hamstring flexibility.

Adolescent idiopathic scoliosis does not usually cause discomfort.

Treatment

The three primary types of treatment for adolescent idiopathic scoliosis (observation, bracing, and surgery) are determined by the risk of curve advancement. AIS curves often proceed in one of two ways: 1. throughout the patient's fast-growing phase, and 2. into maturity if the curves are particularly big.

Because scoliosis worsens with rapid growth, the possibility for growth is assessed by taking into account the patient's age, whether or not she has had her first menstrual period and radiographic data. In general, females mature until they are 14 years old, whereas boys mature until they are 16 years old. Girls develop swiftly until their first menstruation, after which their growth slows, although they continue to grow for another 18 months to 2 years. Growth is also measured using radiographs of the spine and pelvis. The Risser grading system (Figure 1) is frequently used to measure a child's rate of bone formation (how much growth remains) on the pelvis, which coincides with how much spine growth remains. The Risser grading system assigns a score from 0 to 5 to a child's skeletal maturity. Individuals with Risser 0 and 1 are fast-growing, but patients with Risser 4 and 5 are no longer growing.

Patients at a scoliosis clinic will often have their height assessed at each appointment to gauge their growth potential. An X-ray of a patient's hand is also possible. This X-ray may be used to assess a child's skeletal maturity and potential for additional growth by looking at the growth plates (epiphysis) of the fingertips and hand bones.

Curves with large areas are also more likely to have success or deteriorate. Curves larger than 45o in developing patients or more than 50o in finished growing patients will continue to advance slowly over time. This is a general guideline, and your physician will assess if there are any exceptions depending on a variety of criteria.

Treatment Alternatives

Chiropractic medicine, physical therapy, yoga, and other alternative therapies to prevent curve advancement or additional curve progression have not been proven to be effective in the treatment of scoliosis. These and other approaches, on the other hand, can be used if they give a physical advantage to the patient, such as core strengthening or symptom reduction, for example. However, they should not be used to properly treat the curvature with the hopes of improving scoliosis.