What Is Adolescent Idiopathic Scoliosis?
Adolescent Idiopathic Scoliosis (AIS) is a lateral (side) curvature of the spine. The spine may curve to the left or right. Sometimes AIS may start at puberty or during an adolescent growth spurt.
Idiopathic means the abnormal curve develops for unknown reasons. There is most likely a genetic pre-disposition for some adolescents to develop AIS. Three to five percent of adolescents will be found to have some form of scoliosis. Most of these children will be girls, in which curves may be more progressive.
Symptoms of scoliosis include back pain, leg length discrepancy, an abnormal gait, and uneven hips. Patients with AIS may have one shoulder higher than the other, a “prominent” shoulder blade and rib cage when bending forward, and visible curving of the spine to one side. Often the first indication of AIS is when an adolescent or parent notices that clothes no longer fit correctly (for example, the legs of pants may seem uneven).
It is important to seek treatment for AIS because progressive scoliosis, left untreated, can result in significant deformity. The deformity can cause marked psychological distress and physical disability, especially among adolescent patients. Additionally, the deformity can have serious physical consequences. As the vertebrae (spinal bones) rotate, the rib cage is affected, which in turn can cause heart and lung compromise (i.e. shortness of breath). When progressive scoliosis affects the lumbar spine the pain can be debilitating.
An Alternative Treatment That Avoids Rigid Bracing
Dr. Feder has been specially trained in the SpineCor© Bracing program.
This is a unique brace used on children ages 5 to 16, which achieves results through the interaction of the brace with the patient’s corrective movement. Traditional rigid braces are non-dynamic and promote muscle atrophy. The brace is most effective when used before the 1st growth spurt. The most common age group is adolescents ages 12-16. However, adults have had success through use of this unique brace.
SpineCor© is the only brace that preserves the normal body movement and growth while allowing normal daily activities. Patients are encouraged to be physically active while wearing the brace.
The brace is comfortable and may be worn under clothing. This is especially appealing to younger patients, to whom aesthetics are extremely important. This can lead to greater patient compliance, which in turn leads to improvements in health.
What To Expect
On your first visit to our office three types of exams will be performed. It is necessary for the patient to wear form fitting clothing. Girls should wear tighter shorts and a sports bra and boys should wear shorts like bicycle shorts. Loose clothing will hinder our postural and clinical exams.
I. Clinical exam: This is where we will assess the contours of the spine using a scoliometer, which is a device to determine the inclination at certain segments of the spine.
II. Postural exam: During this exam we will assess the shifts, rotations and contours of the patient's posture using a visual inspection and a laser inspection. Certain types of scoliosis create certain postural deformities, which assist in the classification of the scoliosis.
III. X-ray exam: We will take x-rays during this exam. They are back to front standing X-rays of the full spine, a standing side view of the entire spine and a laying front to back view of the full spine. These three views combined allow us to get a very good idea of the classification of scoliosis. The back to front standing view allows us to measure the curves using the Cobb analysis. The side view allows us to see if the normal curves are too flat or too curved or just right. Finally, the laying view allows us to determine the flexibility of the curve, which helps in determining the prognosis for correction or stabilization.
Once all of these exams are completed, we will enter all the data into our Scoliosis Software, which helps us classify the scoliosis and the chances of reducing the curves. Once we complete the exams we should know if the patient is a good candidate for the SpineCor© brace or not. If a patient is a good candidate then we will schedule a date the following week to return to fit the brace. If a patient is not a good candidate then they will be referred to the proper provider for further consultation.