The teenage years bring plenty of challenges, but some teenagers also have to deal with back pain from scoliosis on top of school projects and soccer practice. Adolescent scoliosis affects many young men and women – in fact, most people with scoliosis are diagnosed as adolescents, or between the ages of 10-18.
What is Adolescent Scoliosis?
Adolescent scoliosis, just like adult scoliosis, is a condition in which the spine is abnormally curved to some degree. While a normal, healthy spine should resemble an “I” from the front or back, a spine affected by scoliosis looks more like an “S” or “C.” The vertebrae (the bones of the spine) involved in the curvature may also rotate slightly, which can further impact the body’s overall balance and alignment.
Scoliosis affects about 2 percent of females and 0.5 percent of males in the general population. There are many causes of scoliosis, such as congenital spine deformities, neuromuscular problems, genetic conditions, and leg length inequality. However, more than 80 percent of scoliosis cases are idiopathic, which means there is no known cause and the affected individual is otherwise healthy. In teenagers, these cases are referred to as adolescent idiopathic scoliosis (AIS).
How is Adolescent Scoliosis Diagnosed?
Most kids and teenagers aren’t too concerned about their spinal health. That’s ok in some instances, because many cases of adolescent scoliosis are mild and don’t cause uncomfortable symptoms. However, be sure to visit a doctor if your child begins to notice visible signs of scoliosis:
- One shoulder/shoulder blade that appears higher than the other
- Head is not aligned directly over the pelvis
- One hip that appears higher than the other
- Sides of the rib cages that are at different heights
- The body leans subtly to one side
- Changes in the appearance of the skin over the spine (hairy patches, dimples, color changes)
Pediatricians and school nurses often use a standardized exam known as the Adam’s Forward Bend Test to screen for adolescent scoliosis. During this exam, the patient is asked to lean forward with his or her feet together and bend 90 degrees at the waist. The medical professional performing the exam can easily detect any unusual spinal curvatures or asymmetry from this angle.
If adolescent scoliosis is suspected, a pediatrician will have the patient undergo X-ray imaging, magnetic resonance imaging (MRI) or a CT scan to confirm the diagnosis. From there, the Cobb Method is used to measure the extent of the curvature in degrees. Generally speaking, a curve is considered significant if it is more than 25 degrees and severe if it is more than 45 degrees.
How is Adolescent Scoliosis Treated?
Treatment of adolescent scoliosis will depend on the severity of the curvature, the symptoms it is causing, and the potential for progression. But, one thing is consistent – the earlier scoliosis is treated, the better. That’s because growing kids and teenagers have softer, more malleable bones that are easier to correct, while adults who have reached skeletal maturity are not so easily treated.
There are three basic treatment approaches for adolescent scoliosis:
- Observation – Not all cases of adolescent scoliosis warrant extensive treatment. If the spinal curvature is mild and isn’t causing symptoms, a doctor may simply keep tabs on the patient through routine evaluations.
- Bracing – Bracing is considered the first line of defense for patients who require treatment. There are different types of braces that a doctor may prescribe based on the specific location and severity of the patient’s spinal curve. Some braces must be worn all day, while others only need to be worn at night.
- Surgery – Surgery is typically only recommended for patients who have severe spinal curvatures or do not respond to bracing. Surgeons use spinal fusion to join affected vertebrae together while creating an “internal cast” with medical screws, rods, and plates. This cast supports the spine while promoting proper alignment and stability.
Are There any Potential Risks or Complications?
Any surgery comes with risks and the potential for complications. Be sure to consult with your child’s surgeon about all possible treatment options and the risks they entail. With the right treatment strategy, your child can live life to the fullest without pain and dysfunction from adolescent scoliosis.
Florida Medical Orthopaedics, Sports Medicine & Spine is proud to serve families in Tampa and Wesley Chapel, Florida.