By Robert L. Brady, M.D.
The term Scoliosis was first introduced by the ancient Greek physician Galen and is literally translated as “crookedness.” Physicians today display a fair amount more discretion and sensitivity in discussing medical conditions with our patients, and especially when they affect our children. Therefore, we define Scoliosis as a lateral (side-to-side) curvature of the spine measuring more than 10 degrees on radiographs (x-rays). Adolescent idiopathic scoliosis, which is the most common subtype of idiopathic scoliosis, presents typically between ages of 10 and 13 years old.
Although the cause of AIS still eludes us, we know a few facts. First, AIS has a definite genetic predisposition. Although it is not uncommon for a child or adolescent to be the first in the family diagnosed with AIS, that child or adolescent’s children will have a significantly increased probability of developing AIS. Secondly, we know that the younger patients with larger magnitude curves have a greater risk of progression of their curvature. The overall risk of progression in a patient who presents with AIS between the ages of 10 – 12 years old is 88%.
The screening for AIS usually begins in the 5th or 6th grades and is often performed by school nurses or child’s pediatrician or both. The treatment of AIS involves primarily regular follow-up evaluations and radiographic monitoring for progression of the curvatures. Of the active treatment offered, only bracing or surgery is considered the universally accepted methods of preventing the progression of the curvature or correcting the deformity. Surgery is considered when the curvature progresses greater than 45 – 50 degrees.
The current surgical techniques employed for progressive AIS allows for excellent correction of curvatures and significant improvement of cosmetic deformity. Most normal activities are resumed within 6 months after surgery. We employ the latest technologies when treating scoliosis including genetic testing, minimally invasive techniques and utilization of biologic healing proteins.