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Adolescent Scoliosis

The most common type of scoliosis seen in children is adolescent idiopathic scoliosis (AIS). AIS is defined as scoliosis whose onset occurs after 10 years of age but the cause is not known (idiopathic). The time of highest risk for curve progression in AIS occurs around puberty when the growth rate is the fastest.

Back pain, uneven hips, and asymmetry at the waist and shoulders are common signs of AIS. When asked to bend forward there may be a visible prominence of one of the shoulder blades (often called a rib hump). Sometimes there is a visible curving of the spine when looking at the adolescent’s back.

AIS should be monitored regularly by a spine specialist because of the possibility for the curvature to progress. Scoliosis progression can cause a permanent deformity and pain. If the scoliotic curve becomes excessively large other serious physical difficulties can occur such as shortness of breath due to limited expansion of the lungs. If the curve affects the lumbar spine there can be significant lower back and leg pain.

Rocky Mountain Scoliosis and Spine utilizes ScoliScore to monitor AIS in applicable patient populations. ScoliScore has been developed to identify a genetic risk to progression of a curve and helps predict curves that will or will not become larger.

Treatment

Scoliosis treatment is based on curve progression. Observation, bracing and surgery are the three treatment options common for kids with AIS.

Observation is recommended for kids who have curves of less than 25 degrees.

Bracing is typically for kids that are still growing and have curves that measure 25 to 40 degrees. The goal of bracing is to prevent the curve from getting bigger, but it will not reserve a curve that is already there. Surgery may be avoided if the curve stays less than 40 degrees.

Surgery is recommended for kids with curves larger than 45 - 50 degrees. The goal of surgery is to stop curve progression and to correct curve. Every surgery is planned specific to the child and the extent of the curve. Implants are used to correct the side bend and/or rotation at each level of the spine affected.

Chiropractic medicine and physical therapy are effective for core strengthening and symptom relief. Large scoliotic curves will continue to progress, however, and should be evaluated by a scoliosis specialist.