21 - Late-Onset Idiopathic Scoliosis

Kyle Kesler; Christopher Cychosz; Joshua Holt; Stuart L. Weinstein

doi:10.1016/B978-0-323-63668-1.00021-5

Back

Book chapter

21 - Late-Onset Idiopathic Scoliosis

Kyle Kesler, Christopher Cychosz, Joshua Holt and Stuart L. Weinstein

Benzel's Spine Surgery, pp.200-205.e2

Elsevier Inc, Fifth Edition

2022

DOI: 10.1016/B978-0-323-63668-1.00021-5

View Online

Abstract

Late-onset scoliosis, or adolescent idiopathic scoliosis (AIS), represents a coronal and rotational deformity of the spine. Modern understanding of the natural history of untreated AIS remains largely based on studies published from the 1960s through the early 2000s. AIS curves with greater Cobb angles are at higher risk of progression after skeletal maturity. Variability exists in the literature regarding whether thoracic or double-major curves are most prone to progression. Despite early publications describing scoliosis as having higher morbidity and mortality rates, AIS patients have a mortality rate similar to that of age-matched peers. Pulmonary impairment is a described complication of AIS but is only present as when curves approach higher magnitudes. Additionally, hypokyphosis and abnormal body mass index have detrimental effects on pulmonary function. Although large curves are associated with higher rates of back pain after skeletal maturity, they are not associated with increased rates of disability. Patients with AIS are gainfully employed, married, and able to successfully bear children at rates similar to unaffected peers. The impact of AIS on body image and mental health is a concern. The views of patients are significantly variable, but curve magnitude and rotation (producing rib prominence) are not found to negatively affect body image. An appreciation of the natural history and identification of those treatments that alter the natural history in a positive way guides joint decision-making between physicians, patients, and families.

Natural History

Adolescent idiopathic scoliosis

cardiac

kyphosis

late-onset scoliosis

psychosocial

pulmonary

Details

Title: Subtitle: 21 - Late-Onset Idiopathic Scoliosis
Creators: Kyle Kesler
Christopher Cychosz
Joshua Holt
Stuart L. Weinstein
Resource Type: Book chapter
Publication Details: Benzel's Spine Surgery, pp.200-205.e2
Edition: Fifth Edition
Publisher: Elsevier Inc; Philadelphia, PA
DOI: 10.1016/B978-0-323-63668-1.00021-5
Language: English
Date published: 2022
Academic Unit: Orthopedics and Rehabilitation; Stead Family Department of Pediatrics
Record Identifier: 9984643756102771

Metrics

1 Record Views