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Adolescent Idiopathic Scoliosis

Adolescent Idiopathic Scoliosis (AIS) is a curvature of the spine that can occur in children aged 10 to maturity. The spine may curve to the left or right. Sometimes AIS may start at puberty or during an adolescent growth spurt.

Idiopathic means the curve develops for unknown reasons. We now know that there is undoubtedly a genetic pre-disposition for some adolescents to develop AIS. Scoliosis is actually quite common – in fact, 3-5% of adolescents will be found to have some form of scoliosis. Most of these children are girls.

Dr. Hershman at Florida Spine Specialists is an expert in treating scoliosis. Having been trained by several of the world’s foremost experts in scoliosis, he is able to diagnose and treat all types of scoliosis using the latest techniques in the field. Each child’s case is different, and the treatment plan is tailored to each individual’s specific problems and needs.

Symptoms
Symptoms of scoliosis can include back pain, legs that aren’t equal in length, or an abnormal gait. Patients with AIS may have one shoulder that is higher than the other, a shoulder blade that sticks out, or a rib cage that is more prominent when bending forward. Often, there is also a visible curving of the spine to one side. Many times, the first indication of AIS is when an adolescent or parent notices that clothes no longer fit correctly (for example, the legs of pants may seem uneven).

It is important to seek treatment for AIS because if left untreated, a progressive scoliosis can result in significant deformity. The deformity can cause marked psychological distress and physical disability, especially among adolescent patients. Additionally, the deformity can have serious physical consequences.

As the spinal bones (vertebrae) rotate, the rib cage “twists” around it, which in turn can cause heart and lung compromise. When progressive scoliosis affects the lumbar spine, the pain can be debilitating.

Non-Surgical Treatment

Fortunately, the vast majority of cases of AIS can be treated non-surgically. Small curves (less than 15-20 degrees) are watched over time for progression. At this stage, no specific treatment is needed. Larger curves (between 20-40 degrees) require bracing to prevent further progression of the curve.

Some adolescents find wearing the brace 16 hours every day difficult. Braces can be uncomfortable, can make a child self-conscious (even though they’re usually well disguised under clothing), and can get very hot, especially here in South Florida. However, wearing a brace can often prevent a curve from getting bad enough to require surgery. Unfortunately, even in the most compliant patients, there are some curves that do not respond to bracing.

Surgical Treatment
Surgery may be recommended for curves that are greater than 40 degrees. Surgery for scoliosis involves special surgical implants such as rods and screws, and sometimes hooks and wires as well. The goal is to straighten and balance the spine and secure it in place (fusion) so that the curve doesn’t get any worse as the child grows. Surgery does not cure scoliosis; it is simply a way to help straighten the curve and manage the progression of the disease to avoid greater deformity.