Adolescent Idiopathic Scoliosis

Idiopathic scoliosis, more commonly known as scoliosis, is a spine condition indicated by a sideways curvature of the spine of more than 10 degrees.

Although scoliosis is a particularly common condition that usually does not require treatment, it can call for crucial measures if it reaches a certain degree. Treatments like physical therapy, a brace, or, if necessary, surgery are all options those with moderate to severe scoliosis have to consider.

The condition is usually indicated by symptoms of low back pain, mid back pain, and a general feeling of tightness of the muscles near the thoracic spine, according to Dr. Ryan Hamilton, a doctor of chiropractic who specializes in sports medicine.

“Most patients with scoliosis are female, and it begins around adolescence. This is why we would get checked in middle school physical education for it,” Hamilton said.

Hamilton treats scoliosis mainly for palliative care (decreasing pain), including spinal manipulation and myofascial techniques. These techniques help treat skeletal muscle immobility and pain by relaxing contracted muscles. Some of the techniques include the Active Release Technique and Graston Technique.

Different stages of scoliosis call for various treatments. If a patient with a scoliosis complaint is an adolescent or younger, an orthopedist must determine whether to take action if bracing or surgery is needed. If a patient with scoliosis is an adult, no additional steps need to be taken.

In adults, scoliosis is unlikely to progress or develop a worse curve. Adults can usually maintain their spines with exercise and physical therapy. 

“Patients who are the most active usually have the best outcomes. Whether that is sports, weight training, or general fitness, exercise seems to slow the process for some scoliosis patients and help speed the recovery process if surgery is needed,” Hamilton said.

With pediatric and adolescent patients, there become different options for them to take depending on the degree of the curve.

For adolescents, scoliosis can easily worsen. When bones are growing quickly in young patients, the curvature in their spines can increase by 20 to 25 degrees in a year. When the curve is small, usually patients consider the Schroth Method, which implements strengthening exercises to try and limit the worsening of a curve and possibly decrease it.

When a curve is between 25 and 45 degrees, brace treatment is usually applied. A common misconception about bracing is that it causes the curve to decrease. Instead, it stops the curve from progressing until the patient has stopped growing. Improving a curve can only be done by getting surgery. Even so, wearing a brace is effective in keeping a curve relatively manageable.

Curves that ultimately become 50 degrees or greater may make adolescent patients candidates for surgery. Surgery is done to stop curve progression, stabilize the spine, and correct scoliosis as much as possible. Fusion surgery is typically performed where metal rods and other implants are used to correct and immobilize the spine’s shape.

Curve Degrees by Noelle Erslovas

Curves that ultimately become 50 degrees or greater may make adolescent patients candidates for surgery. Surgery is done to stop curve progression, stabilize the spine, and correct scoliosis as much as possible. Fusion surgery is typically performed where metal rods and other implants are used to correct and immobilize the spine’s shape.

This kind of surgery has been used for decades and has a lot of research supporting its success and safety. Even today, new advancements and research for scoliosis treatments are being performed.

“I think the hardest challenge for younger people with scoliosis is the sense of uncertainty, and not having control over whether the curve will progress with time,” says Dr. Edward Sun, MD, Board-Certified Orthopedic Spine Surgeon.

Sun helps adolescent patients with treatments for scoliosis outside of surgery. Along with this, he also performs surgeries to help treat scoliosis, mainly for adults. 

Throughout the years, changes have been seen in treatments of scoliosis. Sun, himself, has seen a couple during his career.

“We have much better evidence now that brace treatment works, and can minimize the need for surgery for many patients with progressive scoliosis,” Sun said. “Although some patients still require surgery despite bracing, the surgical technique has also improved, with better surgical implants, so a hard brace is usually not needed after surgery.”