Adolescent Idiopathic Scoliosis Overview and Management

Adolescent idiopathic scoliosis is the most common pediatric spinal deformity. It is characterized by a lateral curvature of the spine 10 degrees as measured by the Cobb method. However, the deformity is a complex 3 dimensional deformity that affects all 3 planes. There is no single causative factor but there is a strong genetic influence in the development of the deformity.

Family history and physical examination is often the first indication of scoliosis. The Adams forward bend test is a screening tool used to detect the asymmetry associated with scoliosis. Diagnosis is confirmed with AP and lateral radiographs. Progression of the deformity is associated with growth and different markers have been identified.

Treatment options depend upon the growth remaining for the patient. Observation, bracing and scoliosis specific exercises are nonoperative options available for treatment of mild scoliosis. Severe scoliosis (50 degrees) or those that are likely to progress are usually treated surgically. Posterior spinal fusion remains the gold standard for surgical treatment of scoliosis. Newer technology such as spinal tethers are available but the indications are being refined.

The online version contains supplementary material available at 10.1007/s43465-025-01627-8.