Scoliosis - How It Presents in Adolescents and When Surgery Becomes Necessary?
Scoliosis is a condition characterised by an abnormal lateral curvature of the spine, often diagnosed during adolescence. While many cases are mild and manageable with conservative treatments, some progress to a degree that requires surgical intervention. Understanding how scoliosis presents in adolescents and when to consider surgery is crucial for effective management.
How Does an Adolescent Present with Scoliosis?
Adolescent idiopathic scoliosis (AIS) is the most common type, typically emerging between the ages of 10 and 18. It often develops without a known cause but tends to run in families. Key signs and symptoms include:
Visible Spinal Curvature: Parents or healthcare providers may notice an asymmetry in the spine when the child bends forward, a test known as the Adam’s Forward Bend Test.
Uneven Shoulders or Hips: One shoulder or hip may appear higher than the other.
Prominent Rib Hump: A protrusion of ribs on one side, more noticeable when bending forward.
Postural Changes: A leaning posture or an imbalanced waistline.
Back Pain or Fatigue: While scoliosis is often painless, some adolescents may experience discomfort, especially after prolonged standing or activity.
Conservative Management of Scoliosis
For mild to moderate cases, conservative treatments aim to slow progression and manage symptoms. These include:
Chiropractic Care: Evidence-based chiropractic adjustments, along with posture training, can support spinal health and mobility.
Bracing: A spinal brace is often recommended for curves between 25 and 40 degrees in growing adolescents to prevent further curvature progression.
Physical Therapy: Strengthening and stretching exercises can improve posture and muscular balance.
Monitoring: Regular check-ups with X-rays help track progression and adjust treatment plans accordingly.
When to Consider Surgery
Surgery is generally recommended when scoliosis progresses despite conservative management, particularly in cases where:
The spinal curve exceeds 40-50 degrees and continues to worsen.
The condition leads to significant postural imbalance or deformity that affects daily activities.
There is evidence of respiratory or cardiac complications due to severe spinal curvature.
The patient experiences persistent pain or functional limitations despite non-surgical treatments.
The most common surgical procedure is spinal fusion, which involves realigning and stabilising the spine using metal rods, screws, and bone grafts. While surgery carries risks, advances in techniques have improved outcomes, allowing many adolescents to regain function and lead active lives.
Conclusion
Early detection and intervention are key to managing scoliosis effectively. While many adolescents with scoliosis can lead normal lives with conservative treatments, surgery may be necessary for severe cases. If you or your child is experiencing symptoms of scoliosis, seeking professional evaluation is the best step toward long-term spinal health.