What are the causes?
In the causes of adolescent idiopathic scoliosis, mechanical, metabolic, hormonal, neuromuscular, growth and genetic abnormalities have an important role. So far, these factors have not been fully accepted as a direct cause of this condition. The current concept is that adolescent idiopathic scoliosis is a multifactorial disease with genetic predisposition factors.
How is it identified?
In general, patients with adolescent idiopathic scoliosis present with uneven shoulder height, asymmetry of the waistline (one hip “more out” than the other) or, a rib prominence. In general, the first to notice is the patient or a relative, the general practitioner or the school nurse. Sometimes, the presenting symptom is back pain.
Diagnosis
The necessary images are the anteroposterior and profile x-rays of the entire column, to assess the degree of deformity. We take these radiographs with the patient barefoot and in a standing position, to assess the effect of severity on the deformity.
What is the management?
Scoliosis braces
Its use in adolescent idiopathic scoliosis is controversial. Its effectiveness remains questionable. The logic for the use of supports has been that the application of external forces can guide the growth of the spine.
When is surgery necessary?
What causes adolescent idiopathic scoliosis?
In the causes of adolescent idiopathic scoliosis, mechanical, metabolic, hormonal, neuromuscular, growth and genetic abnormalities have an important role. So far, these factors have not been fully accepted as a direct cause of this condition. The current concept is that adolescent idiopathic scoliosis is a multifactorial disease with genetic predisposition factors.
How is adolescent idiopathic scoliosis identified?
In general, patients with adolescent idiopathic scoliosis present with uneven shoulder height, asymmetry of the waistline (one hip “more out” than the other) or, a rib prominence. In general, the first to notice is the patient or a relative, the general practitioner or the school nurse. Sometimes, the presenting symptom is back pain.
Diagnosis of adolescent idiopathic scoliosis
Primary care physicians perform a detailed medical history, physical examination and radiological studies before referring the specialist. The necessary images are the anteroposterior and profile x-rays of the entire column, to assess the degree of deformity. These radiographs are taken with the patient barefoot and in a standing position, to assess the effect of severity on the deformity.
What is the management of adolescent idiopathic scoliosis?
The most commonly used approach for patients with mild deformity is the observation of scoliosis. Depending on the degree of skeletal development, specialists evaluate patients every 4 to 6 months, to observe the progression of the curve. The interval of follow-up depends on each individual, taking into account the patient's age, the degree of the curve and the skeletal development.
When is surgery necessary?
Almost 10% of adolescents with idiopathic scoliosis will suffer the progression of scoliosis until surgery is necessary, which is usually a good option for the treatment of major clinical deformity or to correct a scoliotic deformity with risk of progression.