Idiopathic scoliosis refers to a case in which the spine curves outward by more than 10 degrees when viewed from the front without any other comorbidities. Idiopathic scoliosis accounts for regarding 85% of all scoliosis and is divided into ▲infantile malformation (0-3 years old) ▲juvenile malformation (4-9 years old) ▲juvenile malformation (10-bone maturation completion period) ▲adult malformation depending on the age of occurrence. .
“The exact cause of idiopathic scoliosis is unknown.”
Although the exact cause of idiopathic scoliosis is still unknown, the following two theories have been suggested.
1. Genetic Factors
The theory suggests that families with a family history of scoliosis have a higher prevalence of scoliosis, suggesting that identical twins are more than 75% more likely to develop scoliosis together. However, the genetic method has not yet been clarified.
2. Hormonal Factors
It has been reported that melatonin deficiency can cause scoliosis, and that the progression of scoliosis is accelerated in patients taking growth hormone.
“Idiopathic scoliosis, if left untreated, it can progress to scoliosis”
Regarding the natural course of idiopathic scoliosis, it is reported that idiopathic scoliosis of 10 degrees or more has a prevalence of 0.5 to 3 per 100 children and adolescents, and patients with scoliosis of 30 degrees or more are reported to be 1.5 to 3 per 1,000 people.
About 5% of patients with scoliosis greater than 10 degrees progress to scoliosis greater than 30 degrees. Mild scoliosis is equally common in men and women, but severe scoliosis requiring treatment is eight times more common in women than in men. Scoliosis of less than 30 degrees does not progress into adulthood, but in cases of severe scoliosis of more than 50 degrees, it progresses regarding 0.75 to 1 degree every year even as adults.
“Idiopathic scoliosis, there are three treatment options”
There are three methods of treatment for idiopathic scoliosis: follow-up, wearing an orthosis, and surgical treatment. For successful non-surgical treatment, early diagnosis of scoliosis through early group screening is important, and it is usually performed in children aged 10 to 12 years. If it is bent outward by more than 7 degrees on the radiograph taken from the front, a detailed examination and continuous follow-up examination for the underlying disease are required.
As for the follow-up method, in adolescents who are still growing, if the angle taken from the front is between 11 and 25 degrees, it is better to conduct radiological examinations every 6 months. It is recommended to perform tests at short visual intervals.
Wearing a brace is only effective during growth and the purpose is to suppress the progression of the scoliosis while allowing the growth of the spine. It is recommended to start wearing when the angle is more than 25 degrees, and it is difficult to expect the effect of the orthosis when it is more than 45 degrees. Because the orthosis needs to be worn for more than 20 hours a day, it can bring a lot of stress, so continuous attention from the guardian is required. It is important to wear it continuously as much as possible, and it is effective in preventing the exacerbation of scoliosis.
Surgical treatment of idiopathic scoliosis is considered in patients with a scoliosis angle greater than 45 degrees. Its main purpose is to correct the current deformity while preventing the progression of the scoliosis. Correcting the external deformation is an important factor, but the patient’s range of motion and muscle strength following surgery must also be considered. Spinal correction is mainly performed through instrument fixation, and surgery is performed through the anterior, posterior, and lateral methods according to the surgical method.
Written by Hidak Medical Correspondent, Sang-Hoon Jang (Neurosurgeon Specialist)
