Adolescent Scoliosis
- Scoliosis is defined as >10° abnormal lateral curvature of the spine in the coronal plane, often associated with axial rotation. 1,2
- Scoliosis can be classified as structural or non-structural (functional). Functional scoliosis can be postural or compensatory. It is non-progressive and correctable by ipsilateral bending. 1,3,4
- Structural scoliosis can be classified into 5 aetiological causes: idiopathic (80%), congenital (10%), or associated with neuromuscular, developmental and other miscellaneous diseases. 3,4
- Idiopathic scoliosis is a diagnosis of exclusion and can be subdivided based on age of onset: infantile (from birth to 3 years – <1% of cases), juvenile (4 to 10 years - 12-21%) and adolescent (>10 years and before skeletal maturity - 2-4%). 1-3,5
- Adolescent idiopathic scoliosis has a prevalence of 0.5-3% and is the most common form of the disease. Females are predominantly affected (female:male ratio 5-10:1) and are more likely to have more progressive disease and severe curves. 2,5
- The Adam's forward bend test is commonly used as a screening test for scoliosis. The test is performed with the patient bending forward at the waist with arms extended and knees straight until the spine parallel with the ground. Observe for asymmetry in the contour of the back when viewed in the horizontal plane. A rib cage deformity known as a “rib hump” is indicative of a scoliosis curve >10°. 2
- Adam's test was 92% sensitive and 60% specific for detecting thoracic curves >20° and 73% sensitive and 68% specific for lumbar curves >20°, when compared with Cobb’s angle as the gold standard. 6
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