What Exactly is Adolescent Idiopathic Scoliosis (AIS)? Let’s take a closer look: *AIS often presents with a lateral (sideways) curvature of the spine that usually develops in preadolescence or early adolescence. Approximately 80% of all scoliosis is idiopathic, meaning that no specific cause has/can been identified. Other less common causes are congenital (present at birth), or are related to other conditions (e.g., Cerbral Palsy or Muscular Dystrophy).

*In a healthy back, the spine appears straight when looked at from behind and curved when looked at from the side. But with scoliosis, often the opposite is true where the spine can appear curved from behind and straighter from the side.

*About 2-3% of the population has some degree of scoliosis.  However, this number varies according to the size of the curve, with larger curves occurring less frequently.

You should know that scoliosis is not the result of carrying heavy things, athletic involvement, sleeping and standing postures, or minor leg length inequalities as commonly believed.

Here Then Are 3 Main Treatment Options You should Know…

First, treatment options should be chosen based on:

1. The size of the curve.

2. The amount of growth the person has remaining.

3. The concerns a person with scoliosis and/or their family may have about his/her overall appearance.

There are 3 main types of treatment: observation, bracing and surgery.

Observation

Younger children with milder curves or teenagers who have stopped their growth but have moderate to severe curves are often followed for a period of time to see if their curve will progress. In general, people with these types of curves should be followed every 6 months to 1 year. This monitoring includes an x-ray that is compared with previous ones to see if the curve has changed.

Bracing

Bracing is the main non-operative treatment used with people who are still growing. Bracing is usually advised for people with curves between 25o and 45o, or who have smaller curves that have shown progression over time.

The purpose of bracing is to prevent the curve from getting any bigger while the person finishes their growth. Bracing is not meant to correct the curve, nor is it intended for people who have stopped growing.

The most common brace used at the Hospital for Sick Children is the thoraco-lumbar-sacral orthosis (TLSO), which is typically worn 20-22 hours per day. Braces are removed for showering/bathing and often for physical activities.

Surgery

Surgical treatment continues to evolve. Today, the technique being used is a spinal fusion (solid union of bones) with instrumentation (metal rods that help to correct the curve, as well as maintain the correction until the fusion is solid).

The goal of surgery is to minimize and prevent the spinal deformity from progressing. The surgeon is challenged with fusing as little of the spine as possible while adequately correcting the existing curve. In addition, surgeons want the patient to return to normal functioning as quickly and safely as possible.

The indications for surgical treatment are relative. Surgery is generally discussed when the curve is greater than 50 degrees or if it continues to progress rapidly despite bracing. However, for surgical management to be pursued, the person must also be unhappy with the appearance of his/her curve. It is important to remember that the person with scoliosis is in control of his/her life and decides to have surgery or not.

If you choose to have surgery, your surgeon will talk to you in detail about the possible risks and complications. After the surgery, your surgeon will guide you in what activities can be done at different stages. In general, most people will return to school at about 1 month after surgery; can return to gentle swimming at 3 months; can participate in non-contact activities at 6 months and return to full activity at 1 year.

3 More Resources To Research for additional information

National Scoliosis Foundation - http://www.scoliosis.org

The Scoliosis Association - http://www.scoliosis-assoc.org/

SpineKids - www.sickkids.ca/spinekids

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