Adolescent Idiopathic Scoliosis

 Overview  |  Concerns for Teens  |  Conservative Treatment  |  Surgical Correction

  Idiopathic...? When there is no clear cause of the curvature in a healthy person, it is called Idiopathic Scoliosis. This type of scoliosis is the result of an abnormal rotation of the vertebra. Scoliosis can involve the upper back (thoracic), mid-back (thoracolumbar), or in the lower back (lumbar). The neck is seldom involved in scoliosis, and is never part of idiopathic scoliosis.

  Adolescent idiopathic scoliosis is the most common type of spinal curvature. It occurs between the onset of puberty and age 18 in otherwise healthy boys and girls. The prevalence of scoliosis in the USA is 2 – 4% for curves as little as 10°. Girls are far more likely to have larger curves and curve progression than boys. We don't know why. For boys, curves are more likely to progress through the late teen years as long as skeletal growth continues.

Causes

  Unlike many types of scoliosis, the cause of adolescent idiopathic scoliosis is unknown. It does seem to run in families but is not strictly inherited. The likelihood of scoliosis is greater where there is a family history. Cases can also occur where there is no family history of scoliosis. The more that is learned about causation, the more complicated this deformity appears to be. Research is ongoing to try and connect the disorder to a specific gene or group of genes.

Signs and Symptoms

  Adolescent idiopathic scoliosis is a painless spinal deformity. The curve in the spine does not cause pain. If pain is present, it should be investigated further and not attributed to the curve.

  The most common physical finding in teens with scoliosis is the prominence of the ribs on one side. This so-called "rib hump" is best observed by parents or health care providers when viewing the teen bending forward. The ribs on one side of the back will often seem higher than the other side. Other findings include one scapula or shoulder blade that may seem more prominent than the other is. Careful observation of the standing teen may also reveal that one shoulder is higher than the other. One hip may seem higher and give the appearance that one leg is longer than the other is (it usually is not). Clothes fit differently than they used to. There are also patients who have a large curve and hide it very well clinically, without much noticeable deformity.

 Overview  |  Concerns for Teens  |  Conservative Treatment  |  Surgical Correction