Spinal Conditions

Adolescent Scoliosis

Adolescent Scoliosis

Scoliosis: An abnormal curvature of the spine occurring in one or more locations, which can manifest in adolescents and infants.

Overview and Causes

Scoliosis involves an atypical curving of the spine, potentially disrupting body balance and limiting normal movement. About 2% of individuals develop this spinal deformity, often emerging before puberty. Its origins may be genetic or linked to various factors:

  • Secondary: Emerges in response to spinal conditions like degenerative disc disease or osteoporosis, leading to what’s known as degenerative adult scoliosis.
  • Congenital: Present from birth.
  • Myopathic: Spinal muscle dysfunction due to diseases such as cerebral palsy or muscular dystrophy.
  • Idiopathic: Occurs spontaneously with an unknown cause.
  • Paralytic: Muscle inactivity around the spine, often due to spinal cord injuries, can lead to imbalance.

Adolescent Idiopathic Scoliosis (AIS) is the most prevalent form, accounting for about 80% of idiopathic cases, typically arising around puberty onset.

Signs and Detection

Scoliosis symptoms include uneven shoulders, a prominent shoulder blade, an asymmetrical waist, or a raised hip.

The Adam’s Forward Bend Test, a standard scoliosis screening performed by pediatricians, involves bending forward to observe any spinal curvature or trunk asymmetry.

Diagnostic confirmation may come through X-rays, CT scans, or MRIs. The Cobb Method measures curvature severity, with angles over 25 to 30 degrees considered significant, and those above 45 to 50 degrees deemed severe, often necessitating intensive treatment.

Management Strategies

Monitoring is crucial to track curve progression, potentially leading to bracing if the curve worsens. Various braces are available, tailored to individual needs:

  • Boston Brace: Commonly prescribed, covering from under the shoulder blades to the lower back and from below the chest to the pelvis.
  • Milwaukee Brace: Features a contoured pelvic girdle and a neck ring, extending from the neck to the pelvis.
  • Charleston Bending Brace: Designed for night-time use, it over-corrects the curvature by bending the spine away from the curve.
  • Providence Brace: Custom-made for night-time use, similar in function to the Charleston brace.
  • Wilmington Brace: A jacket-like orthosis with adjustable straps, made from lightweight plastic, covering the thoracic to the sacral spine.

Surgery is usually considered only when growth has ceased, and non-surgical methods have not sufficed, or when curvature exceeds 40-50 degrees. Surgical aims include alleviating spinal cord pressure, minimizing curvature, halting progression, and preventing further nerve or spinal cord damage.

Surgical interventions carry standard risks like infection or nerve damage, alongside specific risks related to the procedure. This information is intended to provide a broad overview and should not substitute professional medical advice. Always consult with a physician for guidance tailored to your specific condition.

All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.