Adolescent Idiopathic Scoliosis: Prevention
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Dwain M. Daniel, D.C.
How this evidence was rated:
Strength of Recommendation Taxonomy (SORT)
January 14, 2008
The descriptor "idiopathic" provides ample evidence that risk factors or prevention strategies for developing adolescent idiopathic scoliosis (AIS) are limited. There are many causes for scoliosis but fully 80% are classified as idiopathic (1). Investigation in this area is developing and several possible causative factors are currently being discussed in the literature. Among these, to name a few, are genetic influences (2), hormonal changes (3), age of mother at birth (4), platelets, connective tissue disorders, musculature disorders and dysfunction of the posture controlling system (5). Considering the lack of information relating to etiology, of greater clinical importance to the physician and patient is to identify risk factors which may lead to progression of the scoliotic curve. Significant advances have been published which allow the doctor to identify those patients who are in danger of progression, thereby avoiding unnecessary treatment in some and initiation of necessary treatment in others. The natural history of scoliosis reveals few scoliosis patients actually require treatment. In a 10-year follow-up study of 2700 students Karachalios et al found curves of less than 10° increased in 35.8% patients with an average increase of 8°. Surprisingly 14.9% of patients experienced decreased Cobb?s angle. None of these patients required treatment. In those with curves between 10° and 20°, 48.3% progressed between 5° and 14°. Overall 0.15% of the curvatures required bracing and 0.03% required surgery (6). These findings are similar to those found in other studies (7;8).
For the purpose of this paper only risk factors for progression will be discussed.
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Wright N. Imaging in scoliosis. Arch Dis Child 2000; 82(1):38-40.
Andersen MO, Thomsen K, Kyvik KO. Adolescent idiopathic scoliosis in twins: a population-based survey. Spine 2007; 32(8):927-930.
Parent S, Newton PO, Wenger DR. Adolescent idiopathic scoliosis: etiology, anatomy, natural history, and bracing. Instr Course Lect 2005; 54:529-536.
Henderson MH, Jr., Rieger MA, Miller F, Kaelin A. Influence of parental age on degree of curvature in idiopathic scoliosis. J Bone Joint Surg Am 1990; 72(6):910-913.
Ahn UM, Ahn NU, Nallamshetty L, Buchowski JM, Rose PS, Miller NH et al. The etiology of adolescent idiopathic scoliosis. Am J Orthop 2002; 31(7):387-395.
Karachalios T, Sofianos J, Roidis N, Sapkas G, Korres D, Nikolopoulos K. Ten-year follow-up evaluation of a school screening program for scoliosis. Is the forward-bending test an accurate diagnostic criterion for the screening of scoliosis? Spine 1999; 24(22):2318-2324.
Yawn BP, Yawn RA, Hodge D, Kurland M, Shaughnessy WJ, Ilstrup D et al. A population-based study of school scoliosis screening. JAMA 1999; 282(15):1427-1432.
Soucacos PN, Zacharis K, Soultanis K, Gelalis J, Xenakis T, Beris AE. Risk factors for idiopathic scoliosis: review of a 6-year prospective study. Orthopedics 2000; 23(8):833-838.
Rogala EJ, Drummond DS, Gurr J. Scoliosis: incidence and natural history. A prospective epidemiological study. J Bone Joint Surg Am 1978; 60(2):173-176.
Bunnell WP. The natural history of idiopathic scoliosis. Clin Orthop Relat Res 1988;(229):20-25.
Peterson LE, Nachemson AL. Prediction of progression of the curve in girls who have adolescent idiopathic scoliosis of moderate severity. Logistic regression analysis based on data from The Brace Study of the Scoliosis Research Society. J Bone Joint Surg Am 1995; 77(6):823-827.