Research Review: What Is Adult Scoliosis

Outline

•Review of the paper

•Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis, 1(1) •Asher, M. and Burton, D

Introduction

•Scoliosis defined as a lateral curvature of the spine

•Measured in the standing coronal plane

•Utilizing the Cobb’s angle

•Spinal curves of 10 degrees or greater are found within 2.5% of the general population

•Of those people, only 0.25% require a treatment intervention

Risk factors

•Untreated adolescent idiopathic scoliosis does not increase the mortality rate, despite rare cases of curvature progressing beyond 100 degrees

•The rate of shortness of breath is not increased, unless the curvature has progressed beyond 50 degrees as a child, or 80 degrees as an adult

•Functional levels are near normal levels

•Pain prevalence is increased within the population

•Pain severity may or may not be increased

•Mental health is typically not affected

•Self image is often impacted negatively

•Social function including marriage and childbearing may be affected a greater curvature degrees

treatment

•Non operative treatment includes bracing for curvatures above 25 to 35 degrees, or 40 degrees in patients who are within 2 years of being skeletally mature

•Progression of curvature greater than 6 degrees is 20-40% more likely within operative than bracing treatments

•Operative treatment typically results in improvement of curve progression in 40% of cases

Treatment

•Temporary decrease in self image in braced patients

•Operative patients have the usual risks of major surgical interventions

•20 to 28 year follow up with braced and operative patients

•Similar and significant reduction in function and increased pain compared to non-scoliotic controls

research

•Knowledge of adult idiopathic scoliosis natural history and progression is still incomplete and requires further research

•Patients and caregivers require the information to make informed decisions about management of the condition

REFERENCES

Asher, M. and Burton, D. (2006). Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis, 1(1).

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