Adolescent Idiopathic Scoliosis: What You Need To Know
Adolescent Idiopathic Scoliosis or AIS is the most common form of scoliosis. It a diagnostic term for those aged 10-18. Scoliosis is the abnormal curvature of the spine where the bones of the spine twist or rotate towards the left or right side. Scoliosis affects an estimated seven million people in the U.S alone. There are different types of scoliosis that affect children and adolescents. By far, Adolescent Idiopathic Scoliosis (AIS) is commonly inherited. In other words, it is congenital. Often passing from mother to child. However, the exact cause remains unknown.
How Common is AIS?
While juvenile scoliosis While juvenile scoliosis makes up about a fifth of all scoliosis types, adolescent idiopathic is the most common form of scoliosis, typically characterized by an abnormal curvature of the spine, which becomes evident in late childhood or early adolescence. For as many as four children out of 100, the straight, vertical path of the spine curves horizontally to form a “C” or “S” shape. This occurs during the common period of rapid growth, which is typically between the ages of 10 and 17. It is extremely rare for the curvature that results from adolescent idiopathic scoliosis to remain static; progression as the child ages is inevitable without appropriate care that targets the malfunctioning muscles, ligaments, joints or spinal discs.
What Causes a Scoliotic Bend in Teenagers?
While AIS may result from a wide variety of causes, it usually surfaces without any clear correlation to other conditions. The AIS is quite mysterious and spontaneous, which is indicated by the term “idiopathic,” meaning it has no identifiable or definite cause.
Nonetheless, it’s agreed that the condition probably stems from a variety of genetic and environmental factors, including:
- Abnormal bone or muscle growth
- Hormonal problems
- Genetic disposition
- Underlying abnormalities of the nervous symptom
An estimated 30% of the patients suffering from AIS have a history of scoliosis in their families, which affirms researchers’ suspicion that adolescent idiopathic scoliosis may have an inheritable component. Gender doesn’t seem to play any role in contracting AIS, though girls have a higher risk of developing more severe forms of spine curvature that worsen rapidly over time.
Is the AIS Symptomatic or Painful?
In most cases, patients suffering from AIS (Adolescent Idiopathic Scoliosis) don’t exhibit neurological complications or unbearably extreme pain. The common symptoms of AIS include:
- Tilted shoulders: one of the shoulder blades protrudes forward more than the other shoulder as a result of scoliosis.
- A hard time standing straight: the child may lean towards the right or left and may have a hard time standing perfectly straight.
- Asymmetry of shoulder height: the curve in the spine may make one shoulder seem a bit taller than the other shoulder.
- Torso lean: This becomes noticeable when the condition involves a curve in the curve of the lower back (lumbar) or the middle back (thoracic) areas of the spine but with no secondary curve. The upper part of the body might seem to shift to lean towards the left or the right, and one of the hips might appear higher than the other, causing a torso lean.
- Rib hump: This is the most visible sign of AIS, which occurs when the curve in the spine leads to a protrusion of a rib or on the back. This protrusion is visible when looking at the patient’s spine from the rear.
- Leg length discrepancy: You may notice a discrepancy in the leg length of the child where one leg seems to be always longer, affirmed by an abnormal walking pattern.
How is AIS Diagnosed?
When the adolescent is first checked during a scoliosis evaluation, a complete medical history is taken. A history includes all the details that help our doctors of chiropractic understand how much growth the child is still expected to have. Since AIS typically has a strong genetic influence, a family history may be included.
A physical exam follows, which may entail a complete examination of the adolescent’s spine, joints, and muscles. Our goal is to identify as many aberrant functioning structures as possible. During the initial exam, we determine the offending structures to be targeted through treatments. Our clinical teams may use specialized tools to measure the asymmetry of the spine. We will evaluate the side and front curvatures. An x-ray of the entire spine will be ordered to enhance our understanding of the severity of the adolescent’s scoliosis. Our clinical teams use these x-rays to make specific measurements (Cobb angles) to measure the degree of the curvature.
What Can You Get the BEST AIS Treatment in Malaysia?
If your child has adolescent idiopathic scoliosis, it’s best to seek immediate medical attention. While AIS generally has safe and effective management options, the curves may progress over time if they are not promptly treated and monitored carefully. Extreme cases can limit the patient’s ability to enjoy life and can even lead to complex difficulties that press against the surrounding organs.
While some avoid treating mild cases, we proceed with targeted scoliosis treatment. Neglect of mild scoliotic conditions is the main reason why so many adolescents are now being diagnosed with scoliosis. Therefore, even if your child has a curve below 10 degrees, our recommendation is to visit us and get targeted care that will prevent it from worsening. As with any condition, the earlier you start a targeted treatment, the better your chances of overcoming it without surgery. Therefore, ignore the wait-and-see advice you get from others. Scoliosis does not wait; neither should you.
Our centers have the experts you need for accurate spinal mobilization techniques for scoliosis, scoliosis-specific physiotherapy, and targeted spinal rehabilitation. Besides, none in Malaysia have the technology we have when it comes to non-invasive spine care. If your child has scoliosis, there are many therapeutic options out there.
Should you Opt for Bracing of an Adolescent with Scoliotic Spine?
Some recommend bracing for curves from 20 degrees to 40 degrees. However, we have discovered bracing to be of little use for adolescent idiopathic scoliosis, for it further weakens the very muscles and ligaments that need strengthening. Bracing has shown little to no benefit. In fact, many researchers are reporting worsening of conditions, even with the latest or the best of these soft spinal braces. However, we do recommend bracing only for infantile scoliosis, in other words, for those that are not mobile yet: infants and kids under the age of 3.
What are the Risks and Benefits of Spine Surgery?
Curves that extend beyond the 30 degrees threshold are likely to progress into adulthood, may lead to accelerated disc degeneration, increasing back pain and deformity, and may eventually worsen into problems with inhibiting lung and heart function.
Some surgeons recommend surgery even for curves that are less than 30 degrees, but the vast majority of surgeons agree that surgery is an option once the curve progresses beyond the 45-degree mark.
In our opinion, it is usually best to avoid surgery unless all alternative measures fail to produce results. Spine fusion surgeries are typically performed to address AIS; they use small silver rods and bone graft material to straighten the spine and obtain as much correction of the curve as possible. Keep in mind that surgery is not a cure or fix; it is merely meant to keep the spine stable. However, many complicating factors should make surgery an unlikely option for most.
The Non-Surgical Route is Always the Better Option
Nonetheless, the decision to undergo surgery for scoliosis correction should only be reached after a thorough examination, evaluation, and discussion between the surgeon, the patient, and the family. But, before opting for surgical intervention, it might be a good idea to visit one of our non-surgical experts of adolescent idiopathic scoliosis or AIS.