Adolescent Idiopathic scoliosis
What is Adolescent Idiopathic Scoliosis (AIS)
Scoliosis is a condition characterized by an abnormal, side-to-side curve in the spine, which can manifest in different forms depending on when it is diagnosed:
-
Adolescent idiopathic scoliosis: Identified at age 10 and beyond.
-
Early onset scoliosis (EOS), which includes:-
-
Congenital scoliosis: Detected at birth or shortly after.
-
Infantile idiopathic scoliosis: Diagnosed before age 5.
-
Juvenile idiopathic scoliosis: Identified between ages 6 and 9.
-
During adolescence, the spine may not grow straight, instead curving in an "S" or "C" shape, occasionally accompanied by a twist. The severity of spinal curves is measured in degrees:
-
Mild: Less than 20 degrees.
-
Moderate: Between 25 and 40 degrees.
-
Severe: Exceeding 50 degrees.
Some curves remain stable over time, while others progress, worsening with age. Adolescent idiopathic scoliosis tends to affect girls more frequently than boys and often emerges during the rapid growth spurts of early adolescence.
Causes of Adolescent Idiopathic Scoliosis
The term "Idiopathic" denotes a condition with an unknown cause. In the case of adolescent scoliosis, the term "idiopathic" is used because, in most instances, the cause remains unidentified. This is why the diagnosis is commonly referred to as adolescent idiopathic scoliosis.
Ongoing research endeavors aim to unravel the mechanisms behind the development of scoliosis and understand its origins. Approximately 30% of individuals diagnosed with AIS have a family history of the condition, suggesting a possible genetic component. However, the exact interplay between genetic predisposition and environmental factors remains elusive. As scientists delve deeper, they seek to shed light on the intricate factors contributing to the onset of scoliosis.
Symptoms & Signs of AIS
The symptoms of scoliosis vary from one individual to another, encompassing a range of differences such as:
-
Discrepancies in shoulder height
-
Misalignment of the head position (not centered with the body)
-
Variations in hip height or position
-
Irregularities in shoulder blade height or position
-
Differences in the way arms hang beside the body while standing upright
-
Observable asymmetry in the back's appearance when bending forward
Additionally, individuals or their children might notice that their clothes don't drape evenly. Interestingly, most teenagers with scoliosis do not experience pain due to the condition.
Diagnosis of Adolescent Idiopathic Scoliosis (AIS)
In most cases, parents notice this deformity. At Mukund Spine Clinic, Dr. Vivek Badhe performs a complete evaluations which includes child's birth history, medical history, family history. Dr. Vivek will order certain X-rays to see what deformities are there in the bones, if curve is rigid or flexible.
He will also carry out certain measurements on X -Ray to understand the degree of curve. Dr. Vivek will need additional tests such as MRI & CT scans which provide more information.
Treatment of Adolescent Idiopathic Scoliosis (AIS)
Treatment of adolescent idiopathic scoliosis mainly depends on the size & severity of the scoliosis curve. Dr Vivek Badhe at Mukund Spine Clinic offers both surgical & non-surgical treatment options dependening on beforementioned factors.
Dr Vivek tailors treatment for each patient. His treatment may include any of the following:
-
Periodic monitoring:
In this wait and watch approach, patient will have periodic X-rays to watch for any progression of the scoliosis curve. This option is often opted for milder curves. -
Bracing:
Bracing methods can be opted more mild to moderate curves. There are custom-made braces available which control the progression of curve by applying external pressures against the curve while child is still growing. Such braces are to be worn upto 23 hours a day and others are worn overnight. -
Surgery:
Spinal fusion Surgery - This options is usually chosen for moderate to severe curves. Patient with severe pain due to deformity. Patient with other systemic complications due to scoliosis. Dr Vivek Badhe identifies and fuses the vertebrae which are the main culprit in the formation and/or progression of the scoliosis curve. It helps the spine to grow straighter. It can also reduced backpain.
Non-fusion Surgery - There are certain procedure such as Vertebral Body tethering which have very specific indications and it does not involve fusion of the vertebrae.
Long-term Outcomes of Adolescent Idiopathic Scoliosis (AIS)
Untreated scoliosis can progress to severe deformities and potentially trigger significant respiratory issues, underscoring the importance of timely intervention.
The prognosis over the long haul hinges on the extent of the spinal curve in your child. Those with minor to moderate curves typically respond favorably to treatment. However, individuals with moderate curves in the lower back might experience a bit more back discomfort. Fortunately, patients with larger curves often achieve excellent long-term outcomes post-surgery.
For individuals undergoing treatment for other concurrent disorders alongside spinal deformities, long-term care extending into adulthood may be necessary. This underscores the comprehensive approach needed to address the complexities of scoliosis and associated conditions.