Adolescent idiopathic scoliosis (AIS) develops between the ages of 10 and 18 years.
AIS accounts for approximately 90% of idiopathic scoliosis cases.
The diagnosis is one of exclusion and is made after ruling out other causes of spinal deformity such as neuromuscular, congenital, or syndromic disorders.
The vast majority of patients will never require any form of treatment during the course of their lifetime.
Patients with a severe curvature are at risk of further curve progression and may develop long-term problems related to the degree of the deformity caused by this curvature and/or back pain.
It is uncertain whether non-surgical management (i.e., bracing) is efficacious in the treatment of patients with a severe curvature.
Modern surgical techniques have provided a safe treatment option resulting in excellent deformity correction and good long-term patient reported outcomes.
Adolescent idiopathic scoliosis (AIS) is a structural spinal deformity characterised by decompensation of the normal vertebral alignment during rapid skeletal growth in otherwise healthy children. The deformity can be described in terms of altered sagittal and coronal balance as well as abnormal vertebral rotation. This monograph focuses on AIS, as this form of idiopathic scoliosis accounts for the vast majority (approximately 90%) of cases.
History and exam
- presence of risk factors
- age >10 years
- 6 to 12 months post puberty
- postural asymmetry
- absent or minimal pain
- absence of neurological symptoms with normal neurological exam
- paraspinal prominences on forward bending
- scoliometer measurement of >5° at paraspinal prominence
- symmetric abdominal reflexes
Pediatric Orthopaedic Surgeon
Department of Orthopaedics
Nemours Children’s Hospital
RMI declares that he has no competing interests.
Ignacio V. Ponseti Chair and Professor of Orthopaedics
Department of Orthopaedics and Rehabilitation
University of Iowa Hospitals and Clinics
SLW is a former board member of the Journal of Bone and Joint Surgery (ended in 2013); he was involved in a NIH RO1 research grant programme until 2015; and he is an author of several references cited in this monograph.
Associate Chief of Orthopaedic Surgery
The Children's Hospital of Philadelphia
JMF declares that he has no competing interests.
Pediatric Spine Surgery
Shriners Hospitals for Children
AS is a paid consultant for Synthes Spine, Depuy Spine, and SpineVision.
Department of Neurosurgery
AT declares that he has no competing interests.
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