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American Family Physician Jan 2020Adolescent idiopathic scoliosis affects 1% to 3% of U.S. adolescents. It is defined by a lateral curvature of the spine (Cobb angle) of at least 10 degrees in the... (Review)
Review
Adolescent idiopathic scoliosis affects 1% to 3% of U.S. adolescents. It is defined by a lateral curvature of the spine (Cobb angle) of at least 10 degrees in the absence of underlying congenital or neuromuscular abnormalities. Adolescent idiopathic scoliosis may be detected via the forward bend test and should be confirmed with scoliometer measurement. Mild scoliosis is usually asymptomatic; it may contribute to musculoskeletal back pain, but there is no evidence that it causes disability or functional impairment. Patients with severe scoliosis (Cobb angle of 40 degrees or more) may have physical pain, cosmetic deformity, psychosocial distress, or, rarely, pulmonary disorders. Several studies have shown modest benefit from bracing and scoliosis-specific physical therapy to limit progression in mild to moderate scoliosis, but there were no effects on quality of life. Because no high-quality studies have proven that surgery is superior to bracing or observation, it should be reserved for severe cases. There is little evidence that treatments improve patient-oriented outcomes. The U.S. Preventive Services Task Force and the American Academy of Family Physicians 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.
Topics: Adolescent; Child; Evidence-Based Medicine; Female; Humans; Male; Physical Examination; Practice Guidelines as Topic; Scoliosis
PubMed: 31894928
DOI: No ID Found -
Turkish Neurosurgery 2014Scoliosis refers to curves exceeding 10 degrees observed through posterioanterior direct radiography. In fact, the diagnosis for idiopathic scoliosis is accepted to... (Review)
Review
Scoliosis refers to curves exceeding 10 degrees observed through posterioanterior direct radiography. In fact, the diagnosis for idiopathic scoliosis is accepted to exclude already available causes. The aim of this paper was to review the etiopathogenesis, classification systems and the treatment management of idiopathic scoliosis. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' was performed. For the literature review, papers concerning the etiopathogenesis, classification and treatment were selected among these articles. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' yielded 4518 articles published between 1947 and 2013. The main hypothesis put forward included genetic factors, hormonal factors, bone and connective tissue anomalies. King, Lenke, Coonrad and Peking Union Medical College (PUMC) classifications were the main classification systems for idiopathic scoliosis. Exercise, bracing and anterior, posterior or combined surgery when indicated are the choices for the treatment. Every idiopathic scoliosis case has to be managed to its own characteristics. It is the post-operative appearance that the surgeons are perhaps the least interested but the adolescent patients the most interested in. The aim of scoliosis surgery is to restore the spine without neurological deficit.
Topics: Adolescent; Exercise Therapy; Humans; Neurosurgical Procedures; Orthopedic Procedures; Scoliosis; Spinal Fusion
PubMed: 25269032
DOI: 10.5137/1019-5149.JTN.8838-13.0 -
Chinese Medical Journal Feb 2020Etiology of adolescent idiopathic scoliosis (AIS), a complicated three-dimensional spinal deformity with early-onset, receives continuous attention but remains unclear.... (Review)
Review
Etiology of adolescent idiopathic scoliosis (AIS), a complicated three-dimensional spinal deformity with early-onset, receives continuous attention but remains unclear. To gain an insight into AIS pathogenesis, this review searched PubMed database up to June 2019, using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis," "etiology," "genetics," "mesenchymal stem cells," and their combinations, summarized existing literatures and categorized the theories or hypothesis into nine aspects. These aspects include bone marrow mesenchymal stem cell studies, genetic studies, tissue analysis, spine biomechanics measurements, neurologic analysis, hormone studies, biochemical analysis, environmental factor analysis, and lifestyle explorations. These categories could be a guidance for further etiology or treatment researches to gain inspiration.
Topics: Adolescent; Biomechanical Phenomena; Bone Density; Cerebellum; Chromosome Aberrations; Epigenesis, Genetic; Humans; Melatonin; Scoliosis; Vestibular Nuclei
PubMed: 31972723
DOI: 10.1097/CM9.0000000000000652 -
Deutsches Arzteblatt International Dec 2010Scoliosis is a three-dimensional deviation of the spinal axis. The main diagnostic criterion is spinal curvature exceeding 10° on a plain anteroposterior X-ray image.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Scoliosis is a three-dimensional deviation of the spinal axis. The main diagnostic criterion is spinal curvature exceeding 10° on a plain anteroposterior X-ray image. Scoliosis is called idiopathic when no other underlying disease can be identified.
METHODS
Selective literature review and recommendations of the relevant medical societies in Germany and abroad.
RESULTS
Scoliosis in children of school age and above primarily occurs in girls. Its prevalence is 1% to 2% among adolescents, but more than 50% among persons over age 60. The therapeutic goal in children is to prevent progression. In children, scoliosis of 20° or more should be treated with a brace, and scoliosis of 45° or more with surgery. The treatment of adults with scoliosis is determined on an individual basis, with physiotherapy and braces playing a relatively minor role. Adults (even elderly adults) who have scoliosis and sagittal imbalance may be best served by surgical treatment.
CONCLUSION
Scoliosis is common. Early diagnosis makes a major difference in the choice of treatment.
Topics: Adolescent; Child; Child, Preschool; Diagnostic Imaging; Female; Germany; Humans; Incidence; Male; Scoliosis; Young Adult
PubMed: 21191550
DOI: 10.3238/arztebl.2010.0875 -
Child's Nervous System : ChNS :... Jun 2020Adolescent Idiopathic Scoliosis (AIS) is a complex 3D structural disorder of the spine that has a significant impact on a person's physical and emotionalstatus. Thus,... (Review)
Review
BACKGROUND
Adolescent Idiopathic Scoliosis (AIS) is a complex 3D structural disorder of the spine that has a significant impact on a person's physical and emotionalstatus. Thus, efforts have been made to identify the cause of the curvature and improve management outcomes.
AIM
This comprehensive review looks at the relevant literature surrounding the possible aetio-pathogenesis of AIS, its clinical features, investigations, surgicalmanagement options, and reported surgical outcomes in anterior spinal fusion, posterior spinal fusion or combined approach in the treatment of AIS.
Topics: Adolescent; Humans; Kyphosis; Scoliosis; Spinal Fusion; Spine
PubMed: 32314025
DOI: 10.1007/s00381-020-04608-4 -
Archivos Argentinos de Pediatria Aug 2018The objective of this study was to determine the effects of corrective, therapeutic exercise techniques on subjects with adolescent idiopathic scoliosis. A systematic...
The objective of this study was to determine the effects of corrective, therapeutic exercise techniques on subjects with adolescent idiopathic scoliosis. A systematic review was conducted by searching the Cochrane Library Plus, Pubmed, PEDro, and SCOPUS databases. Studies in patients diagnosed with adolescent idiopathic scoliosis that considered corrective, therapeutic exercise as an independent outcome measure and symptoms, functional capacity, Cobb's angle and/or other angles or body asymmetries as dependent outcome measures were included. A total of 9 controlled clinical trials that carried out corrective, therapeutic exercise were included. Corrective, therapeutic exercise appears to have positive effects by reducing symptoms and improving function, as well as various angles and body asymmetries. However, further studies with better methodological quality are required to confirm these outcomes and determine the best therapeutic exercise intervention.
Topics: Adolescent; Exercise Therapy; Humans; Outcome Assessment, Health Care; Research Design; Scoliosis
PubMed: 30016036
DOI: 10.5546/aap.2018.eng.e582 -
American Family Physician Feb 2014Adolescent idiopathic scoliosis is the most common form of scoliosis, affecting approximately 2% to 4% of adolescents. The incidence of scoliosis is about the same in...
Adolescent idiopathic scoliosis is the most common form of scoliosis, affecting approximately 2% to 4% of adolescents. The incidence of scoliosis is about the same in males and females; however, females have up to a 10-fold greater risk of curve progression. Although most youths with scoliosis will not develop clinical symptoms, scoliosis can progress to rib deformity and respiratory compromise, and can cause significant cosmetic problems and emotional distress for some patients. For decades, scoliosis screenings were a routine part of school physical examinations in adolescents. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend against routine scoliosis screening in asymptomatic adolescents, concluding that harm from screening outweighs the benefit because screenings expose many low-risk adolescents to unnecessary radiographs and referrals. In contrast, the Scoliosis Research Society, American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, and Pediatric Orthopaedic Society of North America suggest that the potential benefit of detecting scoliosis early justifies screening programs, but greater care should be used in deciding which patients with positive screening results need further evaluation. The goal for primary care physicians is to identify patients who are at risk of developing problems from scoliosis, without overtesting or overreferring patients who are unlikely to have further problems. Physical examination with the Adam's forward bend test and a scoliometer measurement can guide judicious use of radiologic testing for Cobb angle measurement and orthopedic referrals. Treatment options include observation, braces, and surgery.
Topics: Adolescent; Disease Progression; Female; Humans; Male; Mass Screening; Practice Guidelines as Topic; Scoliosis
PubMed: 24506121
DOI: No ID Found -
Orthopaedics & Traumatology, Surgery &... Feb 2013Scoliosis is a common deformity in many types of neuromuscular disease. Severe spinal curvature can cause difficulty in sitting. Conservative and surgical treatment of... (Review)
Review
Scoliosis is a common deformity in many types of neuromuscular disease. Severe spinal curvature can cause difficulty in sitting. Conservative and surgical treatment of neuromuscular scoliosis differs from idiopathic scoliosis, being more complex and with a higher complications rate. Non-surgical measures rarely fully control progressive scoliosis, but aim to prevent spinal deformities secondary to muscular hypotonia or contracture. Twenty-four hour bracing should be adjusted throughout growth, and may induce functional impairment and loss of independence. Corrective surgery requires multidisciplinary management and perioperative screening. Pelvic obliquity is commonly associated with neuromuscular scoliosis, making sitting difficult: correction needs to be considered during surgical planning. The goal of surgical correction is to obtain and maintain a well-balanced spine above a well-positioned pelvis. Preoperative multidisciplinary assessment enables potential problems of terrain to be anticipated. Respiratory function investigation will guide possible non-invasive perioperative ventilation. Nutritional and psychosocial assessment should also be incorporated in this preparation, as should overall postoperative care. Implementing this overall strategic planning can achieve a good surgical and functional result in the vast majority of cases.
Topics: Humans; Neuromuscular Diseases; Scoliosis
PubMed: 23337438
DOI: 10.1016/j.otsr.2012.11.002 -
Archivos Argentinos de Pediatria Dec 2016Adolescent idiopathic scoliosis is a 3D spinal deformity in frontal, sagittal and axial planes, with high relevance in the pediatric population especially in adolescents... (Review)
Review
Adolescent idiopathic scoliosis is a 3D spinal deformity in frontal, sagittal and axial planes, with high relevance in the pediatric population especially in adolescents and females between 10 years of age and the end of growth spurt and skeletal maturity. The radiographic manifestation is a curve greater than 10° measured by Cobb method associated with vertebral rotation. "Idiopathic" diagnosis has to be done after neuroanatomical anomalies of the posterior cerebral fosa and spinal canal have been ruled out. The physical finding of a thoracic or lumbar hump is the clinical manifestation of vertebral rotation seen in a forward bending test (Adam's Test). It is recommended that all curves with a magnitude greater than 20° have to be controlled and treated by a spinal surgeon being observation, bracing and surgery the different treatment options based on the extent, progression of deformity and basically the clinical condition of the patient.
Topics: Adolescent; Humans; Scoliosis
PubMed: 27869435
DOI: 10.5546/aap.2016.585 -
Acta Ortopedica Mexicana 2023Early-onset scoliosis corresponds to a group of heterogeneous spinal conditions that present before 10 years of age with a curvature in the coronal plane of 10° or... (Review)
Review
Early-onset scoliosis corresponds to a group of heterogeneous spinal conditions that present before 10 years of age with a curvature in the coronal plane of 10° or more. Regardless of the etiology, adequate control of the deformity is required to avoid cardiopulmonary deterioration and preserve quality and life expectancy. Diagnosis can be difficult and is usually incidental at a young age. To choose the best treatment, it is important to consider the patient's age, etiology, and rate of progression. Among the non-operative treatments, the most effective are the use of serial casts or brace, whose main objective is to stop the progression of the deformity and thus delay surgical treatment. Among the surgical treatments the distraction based systems and definitive arthrodesis have proven to be most effective. Early surgery leads to multiple complications, which is why, if feasible, non surgical management should be sought and fusion postponed till skeletal maturity. Due to the life-threatening risks associated with the deformity and treatment, it is important to educate the patient and family members about the importance of treatment adherence and follow-up.
Topics: Humans; Scoliosis; Spinal Fusion; Treatment Outcome; Retrospective Studies
PubMed: 37871933
DOI: No ID Found