Adolescent Idiopathic Scoliosis

Scoliosis is a condition where there is abnormal lateral curvature of the spine that makes the spine appear as “S” or “C” curve. It can occur at any age and is seen more frequently in girls than boys. The exact cause of idiopathic scoliosis is unknown in most of the cases.

Types

There are three types of idiopathic scoliosis based on the age of occurrence.

• Adolescent idiopathic scoliosis: It is the most common type and occurs after the age of 10 years.
• Infantile idiopathic scoliosis: It occurs in children below 3 years and may be present at birth (congenital) or associated with various syndromes or neurologic disorders.
• Juvenile idiopathic scoliosis: It is quite uncommon and occurs in children between the ages of 3 and 10 years.

Idiopathic scoliosis does not cause any pain, nerve dysfunction, or breathing problems. Child’s overall appearance will be the main concern in parents.

Diagnosis

Your doctor will perform Adam’s forward bend test to check if any deformity is present. During this test your child is requested to bend forward. The diagnosis can then be confirmed by measuring the curve with the help of an X-ray of the spine.

Treatment

The treatment of scoliosis is important because if left untreated, the curves measuring more than 50° may cause long term problems such as decrease in lung capacity leading to restrictive lung disease. The kind of treatment needed depends on the degree of the scoliotic curve, the child’s age, and the time period remaining for the child to reach skeletal maturity.

• Nonsurgical treatment
  • Observation: If there is only a mild curve (less than 20°) or if the child is nearing skeletal maturity, regular check-up for every 3-6 months will be sufficient.
  • Bracing: Bracing is done to prevent the progression of scoliotic curves. It is effective in growing children with a spinal curvature between 25° and 45°.
• Surgical Treatment

  Surgical treatment is recommended in cases where the curve is greater than 45° and who have reached skeletal maturity having scoliotic curves that exceed 50° to 55°.

• Procedure

  During the surgery, an implant made up of rods, hooks, screws or wires are used to straighten the spine. Bone grafting may also be done to the operated portion of the spine, to promote healing. Bone grafts can be obtained either from the bone bank or from the patient’s own hip region.