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
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(AIS)
Pedigree Chart
Symptoms of AIS
AIS Testing
AIS Treatment
Observation
Bracing
Surgery
Concluding Thoughts
What is
Scoliosis?
 An abnormal
lateral curve to
the vertebral
column greater
than 10°
 Many different
forms of
scoliosis
 Straight Spine
-has 0° curve
 Curvature of the Spine
-has a curve that is
between 0° and 10°
 Scoliosis of the Spine
-has a curve that is
greater than 10°
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 during
 Greater than 10°
rapid growth
 Otherwise, patients are
healthy
 No known cause
 30% have some family
history
 Genetic connection
 Twisting of the spinal
column
 Spine resembles a “C”
or “S”
 Patients are between 10
and 18 years
Pedigree Chart with Multiple Family
Members affected with AIS
Squares - Males
Circles - Females
Suggests a
dominant
mode of
inheritance
Closed symbols
represent affected
individuals
Symptoms of Scoliosis
The body may tilt to
one side
One shoulder may
appear higher
One side of
the rib cage
may appear
higher
Waist may appear
uneven or hips
elevated
One leg may appear
shorter than the
other
AIS Testing
Adam’s 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
Observation
Bracing
Surgery
Observation
 Consider patient’s 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 patient’s 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
Contrel-Dubousset
Instrument
Harrington Method
 Fusion with one rod hooked
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to the spine
Obsolete “flatback”
Increase wear and tear
Early onset of arthritis
Degeneration of discs
Muscle stiffness
Reliance of painkillers
Further surgery required
Disability
 Fusion with a combination of
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two rods, screws, hooks, and
wires
Modern
Low rate of failure
5-7 Day hospital stay
3-4 Weeks out of school
6 Month recovery time
For more information go to
Scoliosis Research Society (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