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Friday 26 December 2014

Treating adolescent idiopathic scoliosis

Adolescent idiopathic scoliosis is one of the most frequently occurring spinal deformities. In adolescents, it can cause various problems related to growth and adversely impact their studies.





There are various ways to adequately treat adolescent idiopathic scoliosis. Among the many methods of treatment, some are based on scientific evidence while others are not.

Patients need to carefully examine the various types of treatment available in order to receive the safest and most effective.



Causes


Adolescent idiopathic scoliosis occurs between the ages of 10 and 18. The cause of this disease is not as clearly defined as that of other forms of scoliosis, but hormone imbalances, asymmetric growth and muscle imbalances are presumed to be possible reasons.


In terms of hereditary factors, about 30 percent of patients have a previous family history. Many researchers have found some correlation with hereditary causes. However, they have not yet found any direct correlations.


There is a laboratory in the United States that analyzes the genetic factors of adolescent idiopathic scoliosis. Based on 53 different genetic markers and measurements of current angle of spinal deformity, the lab predicts a future curve progression of scoliosis called a "ScoliScore."


The screening test is being developed for commercialization. However, the cost is still very high, and there need to be further verifications of its reliability.



Symptoms
Adolescent idiopathic scoliosis generally does not cause any pain or other neurological symptoms.


Most back pain has no relation to scoliosis. In most cases, patients visit the hospital once they realize the abnormality of their spinal shape, uneven shoulder height, uneven protrusion of their back or an uneven waist line making the patient feel like one leg is longer than the other.



Treatments


There is still some debate as to which treatment is the best for the scoliosis, but the most widespread treatment is wearing a brace or undergoing surgery. If the angle of deformity is less than 25 degree, the progression should be carefully followed by regular examinations and evaluations.


In Korea, many centers promote their ability to correct the scoliosis. While it is true that scoliosis or the imbalances causing temporary pain can be eased by manipulation physiotherapy, there is insufficient evidence that treatments through chiropractic, physiotherapy and yoga can actually correct scoliosis.


These treatments do not correct the scoliosis, but they do help the condition by strengthening the spinal muscles and relieving the pain. Thus, a patient with weak spinal muscles or pain can expect improvement by combining treatment with a rehabilitation program.


If a patient is still growing and has a 25-to-40-degree deformity, wearing a brace is highly recommended, not to correct the scoliosis but to prevent the scoliosis from worsening. If the angle of deformity is greater than 45 degree, then surgical methods such as spinal fusion are necessary.


The writer is director of the spine center at Bumin Hospital Seoul in Gangseo District. He was included in the 2014 edition of "Marquis Who's Who."


Source: Korea Times, 21st Dec 2014

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