What is Adolescent Idiopathic Scoliosis?

  • A common condition that can easily go undetected (1)
  • Scoliosis is defined as a lateral (or sideways) deviation of the spine, minimum Cobb angle 10 degrees, with concordant vertebral rotation (1,2,4)
  • Scoliosis commonly presents as a deformity of the back, more rarely as a chance finding on radiograph or associated with a complaint of pain or unrelated symptoms (4)
  • 85% of all cases of scoliosis are idiopathic (i.e. of no clear underlying cause) (1, 2)
  • Severe scoliosis may have significant physical and psychosocial impact such as decreased pulmonary capacity, back pain and lower marriage rate (2, 4)

Who do we recommend get screening?

Current recommendations for scoliosis screening are to screen girls around 10 and 12 years of age. The dual screenings maximise the opportunity to evaluate girls when progression of the curve is likely to occur. If curves are going to progress, they will often do so during growth spurts. Girls start their spurt prior to menarche.

The current recommendations for boys is age 13 or 14 years.

Benefits of screening for scoliosis

  • Screening is the presumptive identification of unrecognised disease or defect by the application of tests, examinations or other procedures that can be applied rapidly (2)
  • Routine screening for scoliosis facilitates early identification, monitoring and treatment (1)
  • Scoliosis screening programs have been found to be safe (2)
  • Early screening is recommended by:
    • The American Academy of Orthopaedic Surgeons (AAOS)
    • The Scoliosis Research Society (SRS)
    • The Paediatric Orthopaedic Society of North America (POSNA)
    • The American Academy of Paediatrics (AAP)
    • Scoliosis Australia
  • The above organisations recognise the benefits of early detection and the effectiveness of bracing as early, non – operative care (6)
  • Without treatment many curvatures would be expected to worsen over the long term (2)
  • More significant scoliosis in children who may present with no symptoms, can be detected by clinical screening at a time when surgical treatment for their deformity can be performed most effectively (2)

When to screen for scoliosis

  • If curves are going to progress, they will often do so during growth spurts (1)
  • Girls start their growth spurt prior to menarche
  • AAOS, SRS, POSNA and AAP believe that screening programs should be part of the medical home preventative service visits for females at age 10 and 12 years, and males once at age 13 or 14 years (6)
  • The dual screening maximises the opportunity to evaluate girls when progression of a curve is likely to occur.

Is treatment successful?

Yes, modern methods may produce excellent results when a curve is detected early. In most cases an inconspicuous spinal brace is worn. Surgery is needed in approximately one out of three cases which require treatment.

*There is no scientific evidence that physical therapy (exercise programs) and spinal manipulation (chiropractic adjustments) will either correct a scoliosis or halt its progression*

What will happen if Scoliosis is not treated?

The curve may increase unnoticed during the growing years. Moderate and severe curves may also increase in adult life.

Some curves may increase with pregnancy. Severe pain, physical deformity and wear and tear arthritis may occur during middle life. Early detection is important for a healthy future.

How do you detect Scoliosis?

Simply look for it! It only takes 30 seconds.

If you, or a family member, are concerned about scoliosis, or would like to be have a scoliosis screen,  please call WCCC on 95450278 to make an scoliosis assessment with your chiropractor.

 

A HEALTH PROMOTION PROGRAM RECOMMENDED BY THE SPINE SOCIETY OF AUSTRALIA. THE PROGRAM IS ENDORSED BY THE PAEDIATRICS AND CHILD HEALTH DIVISION OF THE ROYAL AUSTRALASIAN COLLEGE OF PHYSICIANS.

 

 

 

 

 

 

 

References:
(1) Gutknecht S, Lonstein J and Novacheck T 2009, “Adolescent Idiopathic Scoliosis: Screening, Treatment and Referral”, A Paediatric Perspective, vol. 18, no. 4, pp 1-6
(2) Sabirin J, Bakri R, Buang ASN, Abdullah AT and Shapie A 2010, “School Scoliosis Screening Programme – A systemic Review”, Medical Journal of Malaysia, December issue, vol. 65, no. 4, pp. 261  -7
(3) Bunge EM, Juttmann RE, van Biezen FC, Creemers H, Hazebroek – Kampschreur AAJM, Luttmer BCF et al. 2008, “Estimating the effectiveness of screening for scoliosis: A case control study”, Paediatrics, vol. 121, no. 1, pp. 9 -14
(4) Goldberg CJ, Moore DP, Fogarty EE and Dowling FE 2008, “Scoliosis: a review”, Paediatric Surgery International, vol. 24, pp. 129 – 144
(5) Minnesota Department of Health 2008, “Adolescent School Screening for Scoliosis in Minnesota. Review of Literature and Current Practice Recommendations. A Working Document.” September issue, pp. 1 -32
(6) Screening for the Early Detection for Idiopathic Scoliosis in Adolescents: SRS/POSNA/AAOS/AAP Position Statement, M. Timonthy Hresko, MD; Vishwas R. Talwalkar, MD; Richard M. Schwend, MD 9/2/2015 v2
(7) Stuart L. Weinstein, Lori A. Dolan, James G. Wright and Matthew B. Dobbs, “Effects of Bracing in Adolescents with Idiopathic Scoliosis”, N Engl J Med 2013; 369: 1512 – 1521 October 17, 2013DOI: 10.1056/NEJMoa1307337