Spine10 – 18 years
Adolescent Idiopathic Scoliosis
A structural lateral curvature of the spine with rotation, of unknown cause, presenting during adolescence — the most common form of scoliosis.
Presentation
- Asymmetric shoulders, waist, and scapular prominence
- Positive Adam forward bend test with rib hump (measured by scoliometer)
Imaging & Workup
- Standing PA and lateral full-spine radiographs
- Cobb angle measurement; Risser sign for skeletal maturity
Treatment
Observation
Curves < 25° with periodic monitoring.
Bracing
25–45° in skeletally immature patients to halt progression.
Surgery
Curves > 45–50° typically managed with posterior spinal fusion.
Clinical Pearls
- Bracing prevents progression, it does not correct the curve
- Left thoracic curves warrant MRI to rule out neural axis abnormality