Questions to PonderWhat is Scoliosis?What is Adolescent Idiopathic Scoliosis (AIS)?How do I know if I have AIS?Is AIS caused by not drinking enough milk or

poor posture?Are girls more likely to have scoliosis than

boys?Is AIS hereditary?What are the treatment options for AIS?

byTosha S. Rhea

OverviewWhat is ScoliosisPrevalence of ScoliosisAdolescent Idiopathic

Scoliosis (AIS)Pedigree ChartSymptoms of AISAIS TestingAIS Treatment

ObservationBracingSurgery

Concluding Thoughts

What is Scoliosis?

An abnormal lateral curve to the vertebral column greater than 10°

Many different forms of scoliosis

Straight Spine-has 0° curve

Curvature of the Spine

-has a curve that is between 0° and

10°

Scoliosis of the Spine-has a curve that is

greater than 10°

Prevalence of Curvature/ScoliosisCurves 10° or less, 3-

5 out of 1,000 people

Curves less than 20° is equal in males and females

Overall, 2% of females and 0.5% of males are affected by scoliosis

Adolescent Idiopathic Scoliosis (AIS)

Side-to-side curveGreater than 10°Twisting of the

spinal columnSpine resembles a

“C” or “S”

Patients are between 10 and 18 years

Curve gets larger during rapid growth

Otherwise, patients are healthy

No known cause30% have some

family historyGenetic connection

Pedigree Chart with Multiple Family Members affected with AIS

Closed symbols represent affected

individuals Squares - Males Circles - Females

Suggests a dominant mode of

inheritance

Symptoms of Scoliosis

Waist may appear uneven or hips elevated

One shoulder may appear higher

One side of the rib cage

may appear higher

One leg may appear shorter than the other

The body may tilt to one side

AIS TestingAdam’s Forward

BendX-ray

This test involves the student bending forward with arms stretched downward toward the floor and knees straight. This angle most clearly shows any asymmetry in the spine and/or trunk. Often preformed in school starting in the fifth grade.

This procedure is needed to confirm the AIS diagnosis, to check the magnitude of the curve, and to check the skeletal maturity of the patient. This will influence the treatment decisions.

AISTreatment

Observation

Bracing

Surgery

ObservationConsider patient’s age

(girls grow rapidly until age 14, boys until age 16)

Consider status of females 1st menstrual period(growth slows down)

Consider x-ray of the spine and pelvis(shows skeletal maturity on a scale of 0 to

5)

BracingUsed with curves between 25° and 40°

during the growth phase

Designed to each patient’s shape

Prevents curve progression

Worn under clothes

Worn all day or just at night

Worn until growth of the spine has stopped

Surgery Treatmentwith Spinal Fusion

Harrington Method Contrel-Dubousset Instrument

Fusion with one rod hooked to the spine

Obsolete “flatback”Increase wear and tearEarly onset of arthritisDegeneration of discsMuscle stiffnessReliance of painkillersFurther surgery requiredDisability

Fusion with a combination of two rods, screws, hooks, and wires

ModernLow rate of failure5-7 Day hospital stay3-4 Weeks out of school6 Month recovery timeFor more information go to

Scoliosis Research Society (SRS)

Concluding ThoughtsScoliosis occurs relatively frequently in the general population. Its frequency depends upon the magnitude of the curve of the spine. Scoliosis of greater than 25 degrees occurs in many people all around the world. However, 60% of curvatures in rapidly growing pre-pubertal children will progress. Screening for Adolescent Idiopathic Scoliosis (AIS) is not necessary until the fifth grade, and beyond that point, boys and girls should have an examination every 6-9 months. It is important to know what to do if a patient already has scoliosis, and what treatment options are available.

Resourceswww.srs.orgwww.ejbjs.orgwww.journals.lww.com/corr/Abstract/

2000/03000/Idiopathic_Scoliosiswww.en.wikipedia.org/wiki/Scoliosis