Adolescent Idiopathic Scoliosis
What is it?
Scoliosis is a lateral spine deviation of more than ten degrees. It affects females to males in a 10:1 ratio and is most common during adolescence. In 80 percent the cause is still unclear.
Although typically asymptomatic, it can occasionally lead to serious issues. For instance, if the spine is deviated by more than 60 degrees it will impact the full expansion of the lungs with breathing difficulties. Cardio-respiratory failure is possible when deviation is greater than 90 degrees.
It is condition to be monitored by serially examining the spine X-rays to see if scoliosis worsens.
The etiology of the illness is still unknown for sure. However, it is possible to be genetically linked because the condition can pass on from generation to generation. Also, specific disorders can cause this syndrome, such as:
- Congenital abnormal spine development
- Cerebral palsy
- Muscular dystrophy
- Spinal injury or infection
- Spinal cord disorders
Symptoms
- The waist or hips are uneven
- One side of the back is more convex than the other when bending forward
- Asymmetrical shoulders
- One shoulder blade is more convex than the other
Patients should see a doctor if any of the four above-mentioned physical abnormalities are present.
Complications
- Chronic back pain
- Breathing difficulties
- Spinal injury
- Spinal infection
- Spinal cord disorders
Diagnosis
During the physical examination, the patient will stand with his front side facing the wall and bend forward with his hands hanging freely to examine for protrusion of the shoulder blades and ribs on both sides. Spine X-rays and magnetic resonance imaging (MRI) can confirm the diagnosis of scoliosis and reveal its severity.
Treatment
When a patient has mild scoliosis, there is typically no need for surgery, but regular check-ups are necessary to be sure that there is no further progression. If there is progression, a back brace might be solid therapeutic option. However, if scoliosis is likely to contribute to future disability, a surgery to treat and stop further scoliosis before future complications develop is needed.
Treatment parameters to consider are the age of bone growth (if the spine has stopped growing, the possibility of further scoliosis is less), degree of the deviation and gender (girls are more likely than boys to have severe scoliosis).
Back brace
If a patient is still growing and the scoliosis is moderate, back brace, although is not curative, can help keep symptoms from worsening. Adolescents who wear back braces can engage in daily activities, including sports. The usage of the back support will end when they are no longer growing.
Surgery
The goals of surgery are to stop further scoliosis while restoring the spine to more normal alignment and anatomy. Dr Branko Krajnovic performs the following surgical procedures to treat scoliosis:
- Scoliosis surgery with implantation of a specialized metal rod device that lengthens – if the scoliosis is severe, surgeon will implant the metal rod oriented along the spinal axis, with the treatment goal to coax the vertebrae to grow along the slat of the metal bar. That’s how scoliosis is straightened and corrected as the spine grows.
- Corrective Scoliosis Surgery with spinal fusion – After the completion of corrective scoliosis surgery, the adjacent vertebrae are fused to keep the spine in the corrected position and prevent deviation following the surgery.
- Corrective Scoliosis Surgery without spinal fusion – a flexible, high-strength cable is tethered to the screws to draw and return the crooked spine to a more normal position. This procedure ensures that the spinal joint retains its functional capacity following surgery.
Recovery
Patients can go about their daily lives, including exercise.
Before the appointment with Dr. Krajnović, it would be good to:
- Make a list of the previous medical illnesses.
- Make a list of medical problems that arise in the family.
- Make a list of the symptoms.
- Make a list of questions to ask the doctor.