What Is Adolescent Idiopathic Scoliosis?
Scoliosis is a condition in which a person’s spine is curved from side to side. Although it is a complex three-dimensional deformity, when viewed from the rear, the spine of an individual with scoliosis may look more like an “S” or a “C” than a straight line. About 2% of women and 0.5% of men have scoliosis. This condition affects approximately 20 million people in the United States.
Classifications:
- congenital
- vertebral anomalies present at birth
- idiopathic (based on onset)
- infantile
- juvenile
- adolescent
- adult
- neuromuscular
- developed as a secondary symptom of another condition
- spina bifida
- cerebral palsy
- spinal muscular atrophy
- trauma
- developed as a secondary symptom of another condition
Signs and Symptoms
AIS is usually not painful, although patients may experience significant emotional distress. It is often found during routine medical examination by the pediatrician or at school health screenings. Some of the signs of scoliosis include:
- uneven musculature on one side of the spine
- a rib prominence and/or a prominent shoulder blade
- uneven hips/leg lengths
- slow nerve action in some cases
- head is not centered directly above the pelvis
- uneven waistline
- leaning of entire body to one side
Diagnosis
Dr. Cho carefully examines every patient who initially presents with scoliosis to determine whether there is an underlying cause of the deformity. During the exam, the patient is typically asked to remove his or her shirt and bend forward (known as the Adams forward bend test) to assess shoulder and/or rib prominence.
Patients are often sent for x-rays to confirm the diagnosis.
Non-surgical Treatment
Management of AIS is determined, in part, by the severity of the curvature and skeletal maturity, which together help predict the likelihood of progression.
For small curves (15-20 degrees), simple observation is all that is needed to see whether the curve worsens over time. For bigger curves (20-40 degrees), a lightweight thoracolumbosacral (TLSO) brace is often recommended to stop the curve from getting worse.
Surgical Treatment
Surgery may be recommended when the curve is bigger than 40 degrees. Spine surgery for AIS has been shown to be an effective method to correct the curve and avoid greater deformity. Traditionally, surgeons performed the procedure from either the front (anterior) or the back (posterior). Dr. Cho performs the surgery from the back of the spine using the latest, scientifically proven techniques and appropriate implants. Unlike some spine surgeons who routinely take patient’s own bone graft from the iliac crest of the hip, which may lengthen recovery time and increase pain, Dr. Cho prefers to use local bone graft from the spine, along with bone bank bone and biologic proteins – another advanced technique that improves the fusion success rate and avoids pain for his patients.