What is Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis (AIS) roughly affects 1 to 3% of U.S. adolescents aged 10 to 18.¹

The progression of AIS to adulthood arising in clinical symptom manifestations is rare but AIS can be a contributing factor to a variety of health concerns. 

Pathophysiology 

AIS is a disease identified by an abnormal curvature of the spine. This spinal deformity is usually idiopathic meaning there is no identifiable cause.

Ideas surrounding the causes of adolescent idiopathic scoliosis include genetics, early exposure to toxins, hormonal dysregulation, and nutritional factors. ²

Puberty is a turning point in the development of scoliosis, where the curve of the spine is the most obvious and diagnosis is easiest.

Scoliosis is typically identified using bend tests, spine topography, and imaging diagnostic tools.

Scoliosis is defined when there is an angle of at least 10 degrees in the coronal plane (the spine shifts to the left or right instead of going straight up and down).³ 

Outcomes of scoliosis

Mild cases of adolescent idiopathic scoliosis can result in impairment such as mobility issues due to misalignment of the hips and spine as well as difficulty breathing.⁴ 

If a patient presents with mild scoliosis, there is likely no severe health risk.

However, scoliosis can decrease the communication between the brain and muscles leading to spinal stenosis, and hip dysplasia, among other neuromuscular diseases, if left unmanaged.⁴ 

Scoliosis can become a severe issue when the spine curvature is 40 degrees or more, with 0.4% of cases progressing to this magnitude.¹

These severe issues range from 

• back pain,
• cosmetic psychosocial stresses,
• development of rib deformities creating pressure on internal organs
• and pulmonary hypertension and breathing difficulties.¹ 

Treatment of adolescent idiopathic scoliosis 

Treatments and management for scoliosis often include the use of braces and specific scoliosis physical therapy exercises and surgery as a last resort.¹

Bracing in mild to moderate AIS is effective particularly while adolescents are still undergoing the growth and development stages of puberty. 

In severe cases, spinal fusion surgery is done to correct the curve of the spine.⁴

However, has not been proven to be more effective than bracing and this surgery comes with significant risks like

• bleeding, 
• loss of nerve function, 
• and even death.¹ 

Take home message 

The early detection and treatment of AIS can effectively reverse and or mitigate spinal deformity, preventing the symptoms that come with it.

A quick screening in medical visits can help catch adolescent idiopathic scoliosis during adolescence, and prevent the condition from worsening into adulthood.

References 

1. Kuznia, A. L., Hernandez, A. K., & Lee, L. U. (2020, January 1). Adolescent idiopathic scoliosis: Common questions and answers. American Family Physician. https://www.aafp.org/pubs/afp/issues/2020/0101/p19.html 
2. Kikanloo SR, Tarpada SP, Cho W. Etiology of adolescent idiopathic scoliosis: A literature review. Asian Spine J. 2019;13(3):519-526. doi:10.31616/asj.2018.0096
3. Aebi, M. (2015). The adult scoliosis. European Spine Journal, 14(10), 925–948. https://doi.org/10.1007/s00586-005-1053-9 
4. Dimeglio, A., Canavese, F., & Charles, Y. P. (2017). Growth and adolescent idiopathic scoliosis. Journal of Pediatric Orthopaedics, 31. https://doi.org/10.1097/bpo.0b013e318202c25d