AIS is a Two Dimensional Deformity of the spine (lateral and rotational)
 

Homepage – Adolescent Idiopathic Scoliosis

 

Adolescent Idiopathic Scolisis is a two dimensional deformity (lateral and rotational) of the spinal column in the absence of associated congenital or neurologic abnormalities.  Onset is between the ages of 10 and 18. Longitudial studies (Yawn et al, 1999; Soucacos et al, 1997) estimate the prevalence as high as 2% of the adolescent population, using a definition of a spinal curve greater than 10 degrees. (A side to side curve of at least 10 degrees with a rotational deformity, of at least 10 degrees, must be present before AIS can be diagnosed.)  Side to side (frontal plane) curves greater than 20 degrees have a distribution of 5 females for every male.  

Viewed from the back, the scoliotic spine may have a S-shape or C-Shape appearance (instead of being straight).  Concurrently, the vertebrae are rotated along their axis.

   Normal Spine compared to a Scoliotic Spine

Etiology:  The etiology of AIS is believed to be multifactorial, including genetic factors. 

       However, Rothbart links the development of abnormal spinal curves to abnormal foot function.

 

        Lumbar curve progresssion linked to abnormal foot motion

 

Classification:  AIS curves are classified by their reaction to side bending (structural vs. compensatory) and their location in the spine.  A curve, which is convex to the right, is classified as a right sided scoliosis and vice versa.  There are four common types of curve patterns:

 

               thoracic – 90% occur on the right side

 

             lumbar – 70% occur on the left side

 

             thoracolumbar – 80% occur on the right side

 

               double major – occur on the right and left side

 

Radiographs are the gold standard for diagnosing Scoliosis.  They must be taken with the patient standing.

 

 

Measuring:  The spinal curves are measured using the Cobb or Goh method. 

 

 

            Cobb method for measuring Scoliosis

 

 

Reasonable normal curves for the adolescent spine are:

 

Sagittal Plane Curves (Kyphosis) – up to 40 degrees

Frontal Plane Curves (Scoliosis) – up to 10 degrees

Rotational – up to 10 degrees

 

Symptoms and Signs:  The Symptoms and Warning Signs of Scoliosis are:

 

  • difference in shoulder height
  • head not centered with the rest of the body
  • difference in hip height or position
  • difference in the way the arms hand beside the body when standing
  • positive Adams Test – scapulas at different heights when bent forward at the waist

  6 Steps - Screening for AIS

 

Prognosis:

 

  Projecting Curve Progressions in Untreated Cases of AIS

 

 

Treatment:

 

Treatment of Scoliosis

  • observation and biyearly examinations (curves between 10-15 degrees)
  • proprioceptive insoles (curves between 15- 25 degrees)
  • combination of proprioceptive insoles and bracing (curves between 25-50 degrees)
  • surgery (unstable curves over 50 degrees)

 

Formetric Studies - Evaluating the affect Proprioceptive Insoles have on spinal curves

 

                    Study 1 (PMs foot) - Rothbart, Xydas and Kattous

 

                Study 2 (PMs foot) - Kattous and Xydas

 

                   Study 3 (PMs foot) - London Orthotic Consultancy

 

                  Study 4 - Diers International

 

 

 

Different Types of Proprioceptive Insoles

 

  • Yawn BP, Yawn Ra, Hodge D et al, 1999. A population-based study of school scoliosis screening.  JAMA; 282:1427-32.
  • Soucacos PN, Soucacos PK, Zacharis KC et al 1997. School-screenig for scoliosis: a prospective epidemiological study in northwestern and cetral Greece. J Bone Joint Surg Am; 79:1498-1503.