Questions to Ponder

What is Scoliosis?
What is Adolescent Idiopathic Scoliosis (AIS)?
How do I know if I have AIS?
Is AIS caused by not drinking enough milk or
poor posture?
Are girls more likely to have scoliosis than
boys?
Is AIS hereditary?
What are the treatment options for AIS?
 by
Tosha S. Rhea
 Overview
What is Scoliosis
Prevalence of Scoliosis
Adolescent Idiopathic
Scoliosis (AIS)
Pedigree Chart
Symptoms of AIS
AIS Testing
AIS Treatment
Observation
Bracing
Surgery
Concluding Thoughts
 What is
Scoliosis? Straight Spine
An abnormal -has 0 curve
lateral curve Curvature of the
to the
Spine
vertebral
column -has a curve that is
between 0 and 10
greater than
10 Scoliosis of the Spine
Many different
-has a curve that is
forms of greater than 10
scoliosis
 Prevalence of
Curvature/Scoliosis
Curves 10 or less, 3-
5 out of 1,000 people

Curves less than 20

is equal in males and
females

Overall, 2% of
females and 0.5%
of males are
affected by scoliosis
 Adolescent Idiopathic
Scoliosis (AIS)
Side-to-side curve Curve gets larger
Greater than 10 during rapid growth
Twisting of the spinal Otherwise, patients
column are healthy
Spine resembles a No known cause
C 30% have some
or S family history
Patients are between Genetic connection
10 and 18 years
 Pedigree Chart with Multiple Family
Members affected with AIS
Closed symbols
Squares - Males represent affected
Circles - individuals
Females

Suggests a
dominant
mode of
inheritance
 Symptoms of Scoliosis
One shoulder may
The body may tilt to appear higher
one side
One side of
the rib cage
may
appear
higher

Waist may One leg may

appear uneven appear shorter
or hips elevated than the other
 AIS Testing
Adams Forward
Bend
This test involves the
student bending forward
with arms stretched
downward toward the
floor and knees straight.
This angle most clearly
shows any asymmetry in
the spine and/or trunk.
Often preformed in school
starting in the fifth grade.
X-ray
This procedure is
needed to confirm the
AIS diagnosis, to check
the magnitude of the
curve, and to check the
skeletal maturity of the
patient. This will
influence the treatment
decisions.
 AIS
Treatment
Observati
on

Bracing

Surgery
 Observation
Consider patients age
(girls grow rapidly until age 14, boys until age 16)

Consider status of females 1st menstrual period

(growth slows down)

Consider x-ray of the spine and pelvis

(shows skeletal maturity on a scale of 0 to 5)
 Bracing
Used with curves between 25 and 40
during the growth phase
Designed to each patients shape

Prevents curve progression

Worn under clothes

Worn all day or just at night

Worn until growth of the spine has

stopped
 Surgery Treatment
with Spinal Fusion
Harrington Method Contrel-Dubousset
Instrument
Fusion with one rod Fusion with a combination of
hooked to the spine two rods, screws, hooks, and
Obsolete flatback wires
Modern
Increase wear and tear
Low rate of failure
Early onset of arthritis
5-7 Day hospital stay
Degeneration of discs
3-4 Weeks out of school
Muscle stiffness
6 Month recovery time
Reliance of painkillers For more information go to
Further surgery required Scoliosis Research Society
Disability (SRS)
 Concluding Thoughts
Scoliosis occurs relatively frequently in the general
population. Its frequency depends upon the
magnitude of the curve of the spine. Scoliosis of
greater than 25 degrees occurs in many people all
around the world. However, 60% of curvatures in
rapidly growing pre-pubertal children will progress.
Screening for Adolescent Idiopathic Scoliosis (AIS) is
not necessary until the fifth grade, and beyond that
point, boys and girls should have an examination
every 6-9 months. It is important to know what to
do if a patient already has scoliosis, and what
treatment options are available.
 Resources
www.srs.org
www.ejbjs.org
www.journals.lww.com/corr/Abstract/2000/
03000/Idiopathic_Scoliosis
www.en.wikipedia.org/wiki/Scoliosis