Adolescent idopathic scoliosis

A scoliosis is a tridimensional deformity of the human spine that usually develops with a children’s growth. It is visible through the side-bending of the spine and also a hump in the back caused by the spine’s rotation.

This image shows a patient with a thoracic right-curved scoliosis (right convex scoliosis).

Severe scoliosis lead in the long-term to a complete deformity of the vertebral bodies of the spine. Once the vertebral bodies are deformed, scoliosis is irreversible. Hence, scoliosis treatment should start early before a child’s growth ends. An early and thorough treatment allows to steer and control the spine’s growth in order to correct the scoliosis and straighten the spine.

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Most scoliosis (approximately 85%) are idiopathic, which means that they have an unknown cause. We assume that an unequal stimulation of nerves and muscles of the spine lead to an asymmetric growth of the muscles and the spine.

Scoliosis is a deformity of the spine that progresses with a child’s growth. This is why during a growth-intensive phase like adolescence/puberty scoliosis progresses fast. Therefore, it is of utmost importance to regularly and thoroughly control a child’s spine during this time. Once the growth phase has ended only the most severe scoliosis progress and worsen. 

Scoliosis is diagnosed clinically with a physical examination of the patient. A scoliotic patient usually shows a deformity of the spine with a spine curved to the side, asymmetry of the shoulders and a hump. The severity of a scoliosis is determined with X-ray images of the spine.

This X-ray image (on the left) shows a double-curved scoliosis with a main toracic curve (on the top) and a minor lumbar curve (on the bottom). The image on the right shows how the scoliosis can lead to an asymmetry and height difference of the patient’s shoulders and scapula.

Scoliosis are classified in different types depending on the location of the curve(s) on the spine:

• Thoracic scoliosis
• Lumbar scoliosis
• Lumbo-thoracic scoliosis
• Single-curved scoliosis
• Double-curved with a major and a minor curve, etc.

Images depicting a thoracic scoliosis (image on the left) and a lumbar scoliosis (image on the right).

The severity of a scoliosis is given by the angle of the spine’s curve which is measured with Cobb’s angle. Scoliosis with a Cobb angle higher than 20º usually require some sort of treatment.

X-ray image of an adolescent idiopathic scoliosis with 50º Cobb angle.

It is also imperative to determine the progression of a scoliosis in time and compare it year for year. In cases where the progression of a scoliosis is fast early surgical treatment should be indicated before the scoliosis worsens and becomes severe.