Overview & Detection

The term “idiopathic” means that the cause of the scoliosis isn’t known—it’s not due to injury, disease, or another known factor. In most cases, the curve is mild and causes no problems, but sometimes it can progress, leading to noticeable changes in posture (such as uneven shoulders or hips) or even discomfort and pain.

Doctors often detect AIS during routine check-ups. They may notice a curved spine, a more prominent shoulder blade on one side, or an asymmetrical waistline. X-rays are typically required to assess the severity of the curve.

Risk Factors

Although the exact cause of AIS remains unknown, several risk factors increase the likelihood of developing the condition:

• Genetics / Family History: AIS tends to run in families.
• Specific Genes: Certain genes may be linked to scoliosis.
• Gender: Girls are significantly more likely to develop AIS, especially curves that progress.
• Age / Growth Spurts: The rapid growth during adolescence (10–14 for girls, 12–16 for boys) may contribute to curve progression.
• Body Asymmetry: Imbalances in growth rates between the two sides of the body can exacerbate the curve.
• Neuromuscular Conditions: Though AIS is idiopathic, adolescents with underlying neuromuscular disorders are at higher risk.
• Hormonal Factors & Low Bone Mineral Density: Hormonal changes and weaker bones may also play a role.
• Physical Activity Levels: Inactivity may be associated with an increased risk, though evidence is not strong.
• Ethnicity: Some ethnic differences in prevalence and severity have been observed.

Treatment Options

Treatment for AIS depends on several factors including curve severity, patient age, and progression. The goal is to monitor and, if necessary, prevent further progression while maintaining overall health and quality of life.

• Observation: For mild curves (typically less than 20°), regular check-ups and X-rays monitor progression.
• Bracing: Recommended for moderate curves (20°–40°) in growing children to prevent further curvature.
• Surgery: Reserved for severe curves (over 40–50°) or rapidly progressing scoliosis, where spinal fusion or other corrective procedures are performed.
• Physical Therapy & Exercise: To improve posture, strengthen back muscles, and enhance overall spinal health.
• Alternative Treatments: Options like chiropractic care, yoga, or acupuncture may help relieve discomfort when combined with conventional therapies.
• Monitoring: Ongoing follow-up is crucial during growth spurts and beyond.

Bracing for Scoliosis

Bracing is a common non-surgical treatment for AIS, especially for children with moderate curves who are still growing. The main goal is to prevent further progression of the spinal curve.

How Bracing Works

• Custom-Made Braces: Each brace is custom-fitted to the child’s torso for a snug and effective fit.
• Pressure Application: The brace applies consistent pressure to the curve to prevent further progression, though it does not typically correct the existing curve.
• Wearing Schedule: Braces are usually worn for most of the day and night (often 18-23 hours), with allowances for sports and hygiene.

Types of Braces

• Thoracolumbosacral Orthosis (TLSO): Commonly known as the Boston brace, covering from under the arms to the hips.
• Rigo-Cheneau: A modern custom brace focused on 3D realignment of the spine.
• Night-time Braces: Worn only during sleep to apply increased corrective pressure.

Importance of Compliance: Consistent and proper use of the brace is critical to its effectiveness. Failure to wear the brace as prescribed may lead to further curve progression and, in some cases, the need for surgical intervention.

Living with AIS

It’s important to know that AIS typically does not cause serious health issues. Most people with AIS live normal, happy, active lives. Regular monitoring during growth spurts and adherence to treatment recommendations are key to managing the condition.