Early Detection
Adolescent Idiopathic Scoliosis (AIS) often develops and progresses during the most rapid time of growth, typically between ages 10-15 years.
AIS Scoliosis can be genetic, but many AIS patients don’t have a family history. However, many signs and symptoms can help parents detect scoliosis in their children earlier. ScoliScreen is an online tool developed to help raise awareness of scoliosis. Please consult your doctor if you have any questions.
Adams’ forward bend test is an easy and reliable way to detect scoliosis in the early stage. Some middle school nurses perform Adams’ bend test annually, and pediatricians often perform the same test during adolescents’ annual checkups. Because scoliosis can progress rapidly during a growth spurt, some children may have curves that go from mild to severe in less than a year. Parents should, therefore, perform the Adams’ bend test on their adolescents more frequently at home.
Cobb Angle
Cobb angle is considered the most important measurement to determine and track the progression of scoliosis. It measures the angles formed from the upper and lower end vertebral endplate lines on x-rays.
Patients having a cobb angle of fewer than 10 degrees don't have scoliosis but rather a minor spinal asymmetry. Patients with a cobb angle greater than 10 degrees have scoliosis.
Cobb Angle | Prevalence | Female:Male Ratio |
|---|---|---|
>10 | 3% | 2:1 |
>20 | 0.5% | 5:1 |
>30 | 0.3% | 10:1 |
>40 | <0.1% | 10:1 |
ATR (Angle of Trunk Rotation)
Scoliosis is a three-dimensional spinal deformity, and the Cobb Angle often only reveals the lateral deformation of the spine. The angle of Trunk Rotation (ATR) can measure sagittal deformity. In the Adams Forward Bend Test, doctors can use a scoliometer or mobile applications like SpineScreen developed by the Shriners Hospitals for Children to calculate the ATR. A degree of 7 or more is often a threshold for scoliosis diagnosis.
Treatment Options
Doctors and patients often decide on treatment plans based on the skeletal maturity, cobb angle, and progression risk.
Monitoring
Most patients with mild scoliosis (10-24 degrees) don’t need medical intervention except regular monitoring with x-rays and ATR measurements from the Adams' forward bend test.
Bracing
With skeletally immature children with curves between 25 and 39 degrees, doctors often prescribe scoliosis braces. Bracing rarely reduces scoliosis curves permanently, but it can slow the progression of the curves.
Schroth
The Schroth Method teaches patients breathing techniques to correct their posture. For patients with mild scoliosis (less than 40 degrees), studies show combining Schroth with bracing helps control or slow down curve progression.
Surgery
Patients with mild scoliosis who manage to control their curves under 30 degrees at skeletal maturity tend to stop progressing and require no further treatment during adulthood. However, curves measuring more than 50 degrees at skeletal maturity tend to worsen by about 1 degree per year throughout adulthood. Therefore doctors often recommend surgeries to AIS patients with curves measuring 50 degrees or more. For young patients whose curves are in their 40s but have significant growth left, their curves almost certainly will progress into the surgery range and should start considering surgery.
Based on the remaining growth and severity of scoliosis, adolescent scoliosis patients have different surgery options to choose from.