Adolescent scoliosis is spine curvature that typically becomes obvious between the ages of 10 and 18. It is usually difficult for doctors to pinpoint an underlying cause, but most cases appear to be linked to both genetic factors and consequences of growth spurts around the time of puberty. Mild forms of adolescent scoliosis typically do not result in serious health problems, but a large curvature can cause pain and fatigue and significantly limit physical activity. Medications, bracing, surgery, or a combination of all three can help to straighten the spine and relieve symptoms over the course of several years.
Scoliosis occurs when the bones on one side of the spine grow more quickly than those on the other side. The result is a tilt or shift of the spine to the left or right. Depending on the size and location of the curvature, a person may have uneven shoulders, an awkward gait, or one hip that is obviously higher than the other. A very large and pronounced curvature can cause the spine to twist and put pressure on the spinal cord, nearby nerves, and the ribcage. Rarely, scoliosis is severe enough to impair the lungs and blood flow to and from the heart.
A young person who has physical signs of adolescent scoliosis or complains of back pain should be brought to a doctor for a thorough examination. A physician can make a base estimation of the degree of spine curvature by feeling the back when the patient bends forward. A measuring tool called a scoliometer is then used to confirm precise angles at different points along the spine. In addition, x-rays and other imaging scans are taken to make sure that nerves and cartilage tissue are not damaged.
Treatment decisions depend on a number of different factors, but generally patients who have curvatures of less than 30 degrees do not need to wear braces or undergo surgery. Doctors simply recommend limiting physical activity, taking pain medications, and attending regular checkups to make sure the condition does not worsen. Curves of 30 to 45 degrees typically indicate the need for bracing. A patient may be instructed to wear a supportive brace only at night or all the time. Braces apply constant, minimal pressure on the spine to gradually realign vertebrae until posture is corrected.
Surgery is rarely performed on patients with adolescent scoliosis, but it may be the only option if curvature is greater than 45 degrees and causes serious physical limitations. A surgeon can fuse vertebrae together to prevent future curving and insert metal rods to improve alignment. Multiple surgeries and physical therapy sessions are often needed into adulthood to correct severe adolescent scoliosis.
