Scoliosis is a condition characterized by a lateral curvature of the spine, impacting nearly 2% of the global population. It frequently emerges during adolescence, particularly during growth spurts prior to puberty. Early detection and ongoing monitoring of scoliosis are crucial in preventing potential long-term complications.

Could your teen have scoliosis?

In a discussion with HT Lifestyle, Dr. Anmol N, Senior Consultant in Neuro Surgery and Spine Surgery at Manipal Hospital in Yeshwanthpur, explained, “The initial assessment typically involves a physical examination to identify indicators such as uneven shoulders or hips. If scoliosis is suspected, an X-ray is utilized to evaluate the severity of the spinal curvature. For mild cases (less than 25 degrees), regular follow-up appointments every six months are advised to track any changes.”

For adolescents with moderate curvatures (25–40 degrees), Dr. Anmol N recommended, “The use of a back brace is often indicated. While the brace does not correct the curvature, it serves to prevent further deterioration of the condition. The length of time the brace must be worn is contingent upon the severity of the curvature and the growth stage of the child. In instances where the curvature exceeds 40 degrees, surgical intervention may be necessary to realign the spine.”

He emphasized, “Spinal fusion is a prevalent surgical technique that involves the permanent joining of the affected vertebrae using rods, screws, and bone grafts. This procedure aims to reduce pain and enhance posture, thereby allowing adolescents to enjoy a better quality of life. Through diligent monitoring, the use of braces, and surgical options when required, healthcare professionals strive to ensure that scoliosis does not impede physical development or overall health.”

The ultimate guide to scoliosis prevention and treatment

Dr. Sunny Kamat, Consultant in Spine Orthopedic Surgery at Manipal Hospital in Goa, emphasized, “Adolescent idiopathic scoliosis (AIS) represents the most prevalent structural variant of scoliosis, with an unknown etiology. This condition impacts the spine in three dimensions and its progression varies based on the child's skeletal maturity and the severity of the curvature. Longitudinal studies reveal that after 50 years, 61% of individuals with untreated AIS report experiencing back pain, although 70% do not encounter significant physical limitations as a result.”

Dr. Kamat further noted, “Some children may observe physical alterations such as asymmetry in the waist, discrepancies in shoulder height, or a noticeable rib hump, while others may remain asymptomatic. Those with more pronounced curves might suffer from back pain that intensifies with physical activity. In these instances, regular clinical and radiographic monitoring is essential, as AIS curves typically progress at an average rate of 1° per month, making biannual evaluations critical.”

For patients who have reached skeletal maturity and present with asymptomatic curves measuring less than 50°, a strategy of observation is advised. However, Dr. Kamat asserted, “In growing children, bracing and physiotherapeutic scoliosis-specific exercises (PSSE) are vital to hinder further progression. The challenge of bracing lies in its objective, which is not to reverse scoliosis but to decelerate its advancement by exerting pressure on the pliable spine.”

Surgical intervention is typically reserved for severe cases where the curvature surpasses 50°. Dr. Kamat explained, “The most frequently performed procedure for AIS is posterior spinal instrumentation and fusion. This technique employs pedicle screws, allowing for direct manipulation of the vertebrae to correct coronal, sagittal, and rotational deformities while preserving as many mobile, unfused segments as feasible. The primary aim is to establish a stable and balanced spine without jeopardizing neurological function.”

Experts highlight the significance of early diagnosis, regular monitoring, and suitable interventions in effectively managing scoliosis and enhancing long-term outcomes for patients.

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