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<\/p>\nBy Rosemary Marchese, Physiotherapist<\/p>\n
Being diagnosed with adolescent idiopathic scoliosis (AIS) can be a \u2018big deal\u2019 to a teenager who is already trying to navigate challenging teenage years.<\/p>\n
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While I have seen many teens take the diagnosis all in their stride, not all find it that easy to cope. Coupled with the often unnecessary dramatisation of the diagnosis, stress can easily build in the patient. Unhelpful comments by even well meaning adults and peers can be disastrous: \u2018You will end up in a wheelchair.\u2019; \u2018You are definitely needing surgery immediately.\u2019 and other comments are not uncommon in this industry according to many of my colleagues.<\/p>\n
So, how can we truly know what the future holds for these patients? And how do we not add to the stress to better help our patients? Knowledge is key! Let\u2019s take a look at some of the findings from one of the most recent reviews of the natural history of scoliosis in adolescents by Weinstein (2019).\u00a0<\/span><\/p>\n Factors in determining major curve progression include:<\/span><\/p>\n In general, major curves that are less than 30 degrees at skeletal maturity tend not to progress, no matter the curve pattern (1). Curve progression risk increases when the major curve is measuring between 50 degrees and 75 degrees at maturity (1). This is particularly true of thoracic curves, whereas patients with major thoracic and lumbar curves tend to have curves that balance with age (1).\u00a0<\/span><\/p>\n Curves less than 30 degrees at skeletal maturity tend to not progress, whereas curves that are between 50 and 75 degrees at skeletal maturity have a higher risk of progression.\u00a0<\/span><\/i><\/p>\n Generally these patients will not have any lung function issues. However, having a Cobb angle of 50 degrees or more at skeletal maturity is a significant predictor of reduced pulmonary function (1). Patients with very large major curves of more than 80 degrees with a thoracic apex have more chances of having shortness or breath compared to patients with major lumbar curves of 50 degrees or more (1).\u00a0<\/span><\/p>\nWill the Curve Progress?<\/strong><\/h3>\n
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What about Lung Function?<\/strong><\/h3>\n
Will there be Pain or Function Issues?<\/strong><\/h3>\n