Adolescent idiopathic scoliosis (also known as “AIS”) is the most common cause of scoliosis in children. It typically becomes noticeable in the early teenage years and is present in approximately 3% of kids under 16 years old. It does have a genetic tendency, so it is very commonly seen in kids who have parents, grandparents, uncles, aunts, or cousins who were previously treated for scoliosis. In most cases, the scoliosis is small and non-progressive and does not require treatment but in a small subset of cases (more commonly in girls), the curves are large and progressive and require active treatment.While AIS is the most common scoliosis and is idiopathic (meaning there is no known cause and the kids are otherwise healthy), some forms of scoliosis are a sign of an underlying condition such as a collagen disorder (e.g. Marfan’s syndrome, Ehlers Danlos syndrome, etc.), a neurologic condition, or a problem with the normal formation of the spinal vertebrae that had not previously been detected.Scoliosis is typically asymptomatic and does not cause back pain, problems with breathing, or problems with internal organ function unless the curves are very large (greater than 75 degrees). Typically it is diagnosed after a parent, friend, or pediatrician notices an asymmetry in shoulder height, one shoulder blade that is more protuberant than another, or waist creases that are asymmetric. Often people think that their child has a leg length discrepancy causing them to appear “off-balance” when it is truly a scoliosis causing that appearance. The presence of severe back pain or neurologic signs or symptoms is not normal for kids with adolescent idiopathic scoliosis and requires further investigation.For small curves less than 20 degrees in children that are close to being done with their growth, no active treatment or monitoring is required. However for curves in the 20 to 30 degree range in children that still have substantial growth remaining, bracing is typically recommended to try to stop any further curve progression until the child is done with their growth. A landmark study published in the
New England Journal of Medicine in 2013 showed that bracing is very effective for reducing the eventual need for surgery in children with AIS. Curves greater than 45 to 50 degrees typically will continue to progress after children are done growing and surgery is recommended to partially correct the scoliosis and to prevent further curve progression.
About the Author
This article was written by Venu M. Nemani, MD, PhD. Dr. Nemani is an orthopaedic spine surgeon that specializes in the treatment of scoliosis in both teenagers and adults. His practice is exclusively focused on the treatment of spinal problems. For more information about scoliosis or other orthopedic problems, contact Raleigh Orthopaedic Clinic. Raleigh Orthopaedic Clinic has five convenient clinic locations in Raleigh, Cary, Garner, North Raleigh and Holly Springs with on-site services, including:
MRI, X-ray, physical therapy, and spinal braces. For more information on scheduling an appointment with Dr. Nemani please call (919) 781-5600 or visit our website at www.raleighortho.com.