1. Did you ever wonder what the doctor was looking for when checking your back during your annual exam?

2. Questions to Ponder What is Scoliosis?
What is Adolescent Idiopathic Scoliosis (AIS)?
How do I know if I have AIS?
Is AIS caused by not drinking enough milk or poor posture?
Are girls more likely to have scoliosis than boys?
Is AIS hereditary?
What are the treatment options for AIS?

3. A View of Adolescent Idiopathic Scoliosis (AIS)by
Tosha S. Rhea

4. Overview What is Scoliosis Prevalence of Scoliosis
Adolescent Idiopathic Scoliosis (AIS)
Pedigree Chart
Symptoms of AIS
AIS Testing
AIS Treatment
Observation
Bracing
Surgery
Concluding Thoughts

5. What is Scoliosis? Straight Spine -has 0° curve Curvature of the Spine
-has a curve that is between 0° and 10°
Scoliosis of the Spine
-has a curve that is greater than 10°
An abnormal lateral curve to the vertebral column greater than 10°
Many different forms of scoliosis

6. Prevalence of Curvature/Scoliosis
Curves 10° or less, 3-5 out of 1,000 people
Curves less than 20° is equal in males and females
Overall, 2% of females and 0.5% of males are affected by scoliosis

7. Adolescent Idiopathic Scoliosis (AIS)
Side-to-side curve
Greater than 10°
Twisting of the spinal column
Spine resembles a “C”
or “S”
Patients are between 10 and 18 years
Curve gets larger during rapid growth
Otherwise, patients are healthy
No known cause
30% have some family history
Genetic connection

8. Pedigree Chart with Multiple Family Members affected with AIS
Closed symbols represent affected individuals
Squares - Males
Circles - Females
Suggests a dominant mode of inheritance

9. Symptoms of Scoliosis One shoulder may appear higher
The body may tilt to one side
One side of the rib cage may appear higher
One leg may appear shorter than the other
Waist may appear uneven or hips elevated

10. AIS Testing Adam’s Forward Bend X-ray
This test involves the student bending forward with arms stretched downward toward the floor and knees straight. This angle most clearly shows any asymmetry in the spine and/or trunk. Often preformed in school starting in the fifth grade.
This procedure is needed to confirm the AIS diagnosis, to check the magnitude of the curve, and to check the skeletal maturity of the patient. This will influence the treatment decisions.

11. AIS Treatment
Observation
Bracing
Surgery

12. Observation Consider patient’s age
(girls grow rapidly until age 14, boys until age 16)
Consider status of females 1st menstrual period
(growth slows down)
Consider x-ray of the spine and pelvis
(shows skeletal maturity on a scale of 0 to 5)

13. Bracing Used with curves between 25° and 40° during the growth phase
Designed to each patient’s shape
Prevents curve progression
Worn under clothes
Worn all day or just at night
Worn until growth of the spine has stopped

14. Surgery Treatment with Spinal Fusion
Harrington Method
Contrel-Dubousset Instrument
Fusion with one rod hooked to the spine
Obsolete “flatback”
Increase wear and tear
Early onset of arthritis
Degeneration of discs
Muscle stiffness
Reliance of painkillers
Further surgery required
Disability
Fusion with a combination of two rods, screws, hooks, and wires
Modern
Low rate of failure
5-7 Day hospital stay
3-4 Weeks out of school
6 Month recovery time
For more information go to
Scoliosis Research Society (SRS)

15. Concluding Thoughts
Scoliosis occurs relatively frequently in the general population. Its frequency depends upon the magnitude of the curve of the spine. Scoliosis of greater than 25 degrees occurs in many people all around the world. However, 60% of curvatures in rapidly growing pre-pubertal children will progress. Screening for Adolescent Idiopathic Scoliosis (AIS) is not necessary until the fifth grade, and beyond that point, boys and girls should have an examination every 6-9 months. It is important to know what to do if a patient already has scoliosis, and what treatment options are available.

16. Resources www.srs.org www.ejbjs.org