The spine has an important role. The spine supports our erect posture, stabilizes our limbs relative to our trunks, supports our abdominal and thoracic regions, and protects our neural elements. The spine is in balance when the head is aligned with the pelvis. Scoliosis is a condition in which the spine is curved in the coronal or frontal plane. The coronal plane is the view from the crown (corona) of the head down. The frontal plane is the view of the body from the front. Scoliosis encompasses curves of 10 degrees and greater.
• Abnormalities in the vertebra at birth.
• Neuromuscular disorders, such as cerebral palsy, myelomeningocele, or
• Connective tissue abnormalities, such as osteogenesis imperfecta, Marfan’s
syndrome, or Ehlers – Danlos syndrome.
• Other injuries to the developing spine.
In the adolescent, the most common cause of spinal deformity is idiopathic which means
unknown. While the cause of adolescent idiopathic scoliosis remains unknown, we are currently researching possible causes that may include genetic predisposition, vestibulobasilar or central nervous system causes, or growth pattern asymmetries. It appears most likely that adolescent idiopathic scoliosis is the result of multiple factors including genetic and environmental influences.
When an adolescent is identified with scoliosis, management should be guided by informed choices by the patient, family members, and the health care provider. Management options are determined by the:
• degree of the deformity
• location of the deformity
• cause of the deformity
• age of the patient
• skeletal maturity of the patient
• individual preferences of the patient and family
For AIS, natural history studies provide important information regarding the prognosis of the curve types that affect adolescents. Despite this knowledge, individual curves behave quite differently and should be managed by experienced judgment and expectant observation rather than rules or strict guidelines.
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