Adolescent idiopathic scoliosis (AIS) is the most common form of pediatric scoliosis. U.S. Preventive Services Task Force. The largest age group diagnosed with scoliosis is between the ages of 10 and 18, and among that group, approximately 80 percent of those cases are classed as ‘idiopathic’. The inclination angle measured by the scoliometer will help determine which patients may need radiography. Results of a randomised controlled trial. Inter- and intraobserver reliability assessment of the axial trunk rotation: manual versus smartphone-aided measurement tools. The patient stands and bends forward at the waist. The cutoffs at which radiography is ordered vary from 5 to 7 degrees of trunk rotation via scoliometer. 2013;369(16):1512–1521. *—Risser grade of 0 or 1 reflects skeletal immaturity, which increases the risk of progression and warrants earlier intervention. 2013; 369:1512-1521. Bray C, How Useful Is Physical Examination in Detecting Clinically Significant Scoliosis? US Preventive Services Task Force, et al. bracing can significantly slow mild to moderate curvature progression. et al. et al. early onset - typically defined as onset at age < 5 years, but may extend up to age 10 years ; late onset - onset at age > 5 years ; congenital scoliosis 1,2 Bettany-Saltikov J, Reprints are not available from the authors. Adolescent Idiopathic Scoliosis 10 years. Identifying idiopathic scoliosis at birth or in early childhood is rare. 2001;64(1):111–116. Asher MA, Ashworth MA, Scoliosis. The evaluation of curvatures in conjunction with the level of skeletal maturity will help to guide the management of the curvature. Horne JP, N Engl J Med. et al. Adolescent idiopathic scoliosis: a comprehensive approach to aetiology, diagnostic assessment and treatment. Adolescent idiopathic scoliosis (AIS) (sometimes referred to as “teenage scoliosis”) is defined as a lateral curvature of the spine greater than 10 degrees accompanied by vertebral rotation and is present in 2 to 4 percent of children between 10 and 16 years of age. Long-term outcome of posterior spinal fusion for the correction of adolescent idiopathic scoliosis. Adolescent idiopathic scoliosis: diagnosis and management. 15. Although most patients with adolescent idiopathic scoliosis are asymptomatic, a small minority develop clinical symptoms such as physical discomfort and respiratory compromise with social and psychological consequences such as cosmetic deformity and psychological distress, all of which can reduce quality of life, The U.S. Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP) found insufficient evidence to assess the balance of benefits and harms of screening for adolescent idiopathic scoliosis in children and adolescents 10 to 18 years of age, Scoliosis is often brought to the attention of clinicians by the patient, caregivers, or school-based screening programs. Adolescent Scoliosis Adolescent idiopathic scoliosis (AIS) is a scoliosis that affects children or adolescents from the age of 10 into young adulthood. The scoliosis database was searched for patients with adolescent idiopathic scoliosis who were at least 15 years of age at last review and who had adequate documentation of curve parameters. Franko OI, et al. Women Health. Data Sources: We began with an initial evidence summary that included relevant POEMs, Cochrane reviews, evidence-based guidelines, and other items from Essential Evidence Plus. Patient information: A handout on this topic is available at Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. It … ANGELA L. KUZNIA, MD, MPH, is an assistant professor of family medicine at the University of Michigan Medical School, Ann Arbor.... ANITA K. HERNANDEZ, MD, is an assistant professor of family medicine at the University of Michigan Medical School. Several recent studies show that bracing and scoliosis-specific physical therapy provide modest benefit in limiting Cobb angle progression in patients with adolescent idiopathic scoliosis; spinal surgery remains poorly studied. Reamy BV, The term “idiopathic” means the cause is unknown. a 2013 randomized controlled trial found modest benefits from scoliosis-specific therapy. Ahmed EB, Talwalkar V, affecting children between ages 10 to 18; it’s found in as many as 4 in 100 adolescents Dolan LA, Dolan LA, As adolescents with idiopathic scoliosis age, their condition changes mainly in terms of pain and progression. For information about the SORT evidence rating system, go to It occurs in individuals between the ages of 10 to 18. About 3% of adolescents have scoliosis.Most cases of scoliosis are mild, but some spine deformities continue to get more severe as children grow. Zhu Z, Get Permissions, Access the latest issue of American Family Physician. A systematic review of the literature. 2010 May 1;35(10):1061-71. doi: 10.1097/BRS.0b013e3181bcc835. Idiopathic Scoliosis is the most common spinal deformity that develops in otherwise healthy children. et al. What Examination and/or Radiologic Findings Warrant Referral? Asher MA, Owens DK, et al. McKean G, Ohlin A, Skaggs DL. McKean G, 22. US Preventive Services Task Force. Accessed January 9, 2019. Scoliosis that develops after 10 is referred to as adolescent idiopathic scoliosis. Other potential harms of bracing include body pain, physical limitations, anxiety, and depression.18. Idiopathic scoliosis in adolescents: screening. Ghandhari H, Ameri E, Nikouei F, Haji Agha Bozorgi M, Majdi S, Salehpour M. Scoliosis Spinal Disord. JAMA. Although bracing may slow curve progression in mild to moderate scoliosis, there is insufficient evidence that early detection and treatment improve health outcomes. Adolescent idiopathic scoliosis (AIS) is the most common form of idiopathic scoliosis, occurring at the age of 10 years or greater. Ambrosini E, The sensitivity and specificity of the scoliometer are about 83% and 87%, respectively, using a cutoff of 7 degrees of trunk rotation for a Cobb angle greater than 10 degrees; the sensitivity rises to 100% when a threshold of 5 degrees is used, but the specificity falls to 47%.15 The lower cutoff of 5 degrees of trunk rotation should be used in patients with body mass index in the 85th percentile or more.13 Radiography should be ordered for any adolescent with an obvious curve on physical examination or with readily apparent thoracic or lumbar asymmetry in those with a family history of scoliosis, and for monitoring of progression in patients who have been previously diagnosed.16. Adolescent idiopathic scoliosis is a lateral curvature of the spine (i.e., the Cobb angle) of 10 degrees or more that affects adolescents 10 to 18 years of age. By definition, idiopathic scoliosis implies that the etiology is unknown or not related to a specific syndromic, congenital, or neuromuscular condition. 2005) The total number of scoliosis cases in the United States is estimated to be greater than 4 million. 19. Adolescent idiopathic scoliosis is a lateral curvature of the spine (i.e., the Cobb angle) of 10 degrees or more that affects adolescents 10 to 18 years of age. 3. 2014;23(6):1204–1214. December 30, 2013. A = consistent, good-quality, patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. Adolescent idiopathic scoliosis (AIS) is the most common form of structural spinal deformities that have a radiological lateral Cobb angle — a measure of spinal curvature — of ≥10o. Infantile idiopathic scoliosis – diagnosed under age 5. The sub types of scoliosis are based on the age of the child at presentation. Adolescent idiopathic scoliosis is diagnosed in children between the ages of 10 and 18 years old and represents 80 percent or more of all cases. Post M, Verdun S, Roussouly P, Abelin-Genevois K. Eur Spine J. et al. According to the age of onset, idio-pathic scoliosis can be classified as infantile, juvenile, and adolescent [1, 2]. ; [3] Screening adolescents without symptoms for scoliosis is of unclear benefit. Want to use this article elsewhere? Spine (Phila Pa 1976). There are significant efforts being made toward identifying the cause of AIS, but to date there are no well accepted causes for this particular type of scoliosis. Adolescent idiopathic scoliosis: radiologic decision-making. Infantile idiopathic scoliosis affects patients younger than 3 years, juvenile idiopathic scoliosis appears in children between 3 and 10 years, and adolescent idiopathic scoliosis (AIS) occurs in skeletally immature patients older than 10 years. Spine (Phila Pa 1976). et al. It is important to be able to make this diagnosis but more importantly exclude other causes of scoliosis by carrying out a thorough history and examination. Scoliosis: diagnosis and current treatment. Hasserius R, What Is the Clinical Significance of Adolescent Idiopathic Scoliosis? Juvenile … Hresko MT, Scoliosis is a sideways curvature of the spine. Recommendations are now that females are screened twice, at age 10 and 12 years, and males once at age 13 or 14 years. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Adolescent idiopathic scoliosis affects 1% to 3% of U.S. adolescents. However, the female-to-male ratio increases substantially with increasing size of curve, rising from 1.4:1 in curves from 10° to 20° up to 10:1 in … Clinical examination including the forward bend test and use of a scoliometer can reliably determine which patients require further evaluation or referral. 2014;34(8):774–779. A healthy spine provides the main support for the body, allowing a person to stand and sit upright, walk, bend, and twist. Curve magnitude does not correlate with back pain severity. In multiple studies of middle-aged adults who were treated with bracing vs. surgery during adolescence, there was no difference in quality of life in adulthood between the two groups.3,23, This article updates previous articles on this topic by Horne, et al.2; Reamy and Slakey7; and Greiner.24. Am Fam Physician. Adolescent idiopathic scoliosis (AIS) by definition occurs in children over the age … Adolescent idiopathic scoliosis has an overall prevalence of 0.5–5.0.% with females and males being equally affected. Early detection of idiopathic scoliosis in adolescents. Idiopathic scoliosis comprises the vast majority of cases presenting during adolescence. most common type of idiopathic scoliosis ; more common in girls ; can also be classified as . Adolescent idiopathic scoliosis is the type of scoliosis seen most frequently by spine surgeons and comprises 80% of all spinal deformities. 13. et al. Adolescent idiopathic scoliosis (AIS) is the most common form of idiopathic scoliosis, occurring at the age of 10 years or greater [3]. The type of scoliosis is generally categorized by age at onset of diagnosis: Infantile idiopathic scoliosis, from birth to 3 years old 2008;30(10):799–807. Burden of Disease. Scoliosis is often brought to the attention of clinicians by the patient, caregivers, or school-based screening programs. Usman S. According to Scoliosis Research Society, adolescent idiopathic scoliosis (AIS) is defined as scoliosis in patients above ten years of age to skeletal maturity, which accounts for the majority of idiopathic scoliosis cases.1-5 Many studies have documented that neuraxial pathologic conditions can be Adolescent idiopathic scoliosis: review and current concepts. Patients with severe scoliosis (Cobb angle of 40 degrees or more) may have physical pain, cosmetic deformity, psychosocial distress, or, rarely, pulmonary disorders. Typically it is noticed around 11 to 12 years of age in girls and a little later in boys. 1996 May 15;53(7):2327-35. Newton PO. Marti CL, Glassman SD, Knott PT, Carreon LY, Hresko MT. Adolescent idiopathic scoliosis: diagnosis and management. This content is owned by the AAFP. Sci Rep. 2018 Nov 2;8(1):16296. doi: 10.1038/s41598-018-34261-6. Weiss HR. Exercises for adolescent idiopathic scoliosis. Early onset scoliosis (EOS), including: Congenital scoliosis – diagnosed at birth or shortly after birth. Ambrosini E, Instead of growing straight, the spine develops a side-to-side curvature, usually in an elongated "s" or "C" shape, and the bones of the spine become slightly twisted or rotated. Inter- and intraobserver reliability assessment of the axial trunk rotation: manual versus smartphone-aided measurement tools. Those with lesser curvatures can be monitored unless there are signs or symptoms suggesting an alternative diagnosis. Adolescent idiopathic scoliosis may be detected via the forward bend test and should be confirmed with scoliometer measurement. Referral should be considered for those with severe scoliosis or curvature and musculoskeletal symptoms suggestive of an alternative diagnosis. A study of the diagnostic accuracy and reliability of the scoliometer and Adam’s forward bend test. Diagnosed with Adolescent Idiopathic Scoliosis and treated using the Boston Brace at age five and a half. right thoracic curve most common. Outcome of spinal screening. Am Fam Physician. Cochrane Database Syst Rev. Wright JG, No treatment had been provided for multiple years prior to initial visit. Sign up for the free AFP email table of contents. Am Fam Physician. Xu L, It is unclear whether any treatment mitigates symptom progression into adulthood or improves long-term quality of life.
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