Growth conditional crooked back (adolescent idiopathic scoliosis)
Rehab of the injury

Easy-moderate (8-15 year old) – Moderate-hard (12år+)

Description of growth-related lumbar spine (Adolescent idiopathic scoliosis)

One can get a crooked back for various reasons. A crooked back is called scoliosis, and can occur for various reasons; from unilateral asymmetrical training, crooked pelvis, uneven leg length, locking in the back or due to pain. The most common form of crooked back in adolescents and children over 10 years of age is called adolescent idiopathic scoliosis. Adolescent means that the person is not yet fully developed in the skeleton. Idiopathic means without known cause. It affects 2-3% of children and young people between the ages of 10-18, and is more than twice as common in girls than in boys. It is not known why the condition occurs, but most research indicates a genetic predisposition.

For most people, the condition is discovered by the parents, or a doctor, sometimes in connection to another condition, as there are rarely any symptoms in the beginning. Others discover it first because their clothes do not fit properly. Gradually, symptoms such as pain in the chest, between the ribs and poorer movement begin to appear. Later, in severe cases, it can even affect function of the heart and lungs.

Whether the condition worsens depends on a lot of different factors; the patient’s age, sex, and degree of current scoliosis. It is most often the case that the younger you are when scoliosis is diagnosed, and especially if you are a girl, the greater the probability that the scoliosis requires intensive treatment and even surgery. In a study of children aged 10 years or younger with a small curve (from 5-19 degrees), there was a 45% chance that the condition developed, while a mean curve (from 20-29 degrees) all had almost a 100% chance for scoliosis to develop further.

Facts:

  • Idiopathic scoliosis is described on the basis of 4 curve types, which are named after their location.
  • A thoracic curve (chest curve) is the most common in an idiopathic scoliosis where 90% occurs on the right side.
  • A double head curve describes a right breast and a left lumbar curve.
  • A thoracolumbar curve (chest-lumbar curve) is also quite common with 80% on the right side.
  • A lumbar curve is usually found only on the left side.
Symptoms of growth-related lumbar spine (Adolescent idiopathic scoliosis)
  • The shoulders are asymmetrical.
  • It is difficult to stand up straight.
  • If one shoulder blade is more posterior.
  • The rib arch is asymmetrical.
  • The flank (side of the body) has a fold on one side which is not on the other.
  • If the pelvis is pushed forward, the back will be asymmetrical.
  • An abnormal gait pattern.
Study of growth-related lumbar spine (Adolescent idiopathic scoliosis)
  • Remember it is typically a genetic condition where someone in the family has it.
  • Typically, you do a study where you find out if the back is straight. Here you can see the air distance between arms and flank.
  • Scoliosis is also present whilst bending forward.
  • You can also evaluate using a special device called a Scoliometer, where you measure the asymmetry when the back is flexed. There is an app for this for smartphones, but there is no evidence as to whether they work properly.
  • X-ray examination confirms the condition, evaluating both the curvature to the side and forward. Then you make some special calculations based on what is called the Cobb method. Cobb is about calculating the degree of the angle. First you take an X-ray and then you use a computer program to measure the curve between the most angled vertebrae. Most scoliosis curves are between 10-40 degrees. But most often you keep an eye on whether the angle changes, in order to be able to document whether the condition is worsening.
Treatment of growth-related lumbar spine (Adolescent idiopathic scoliosis)
  • Most patients with idiopathic scoliosis have very small curves and these respond well to treatment. Here, symmetrical training of back stability is the most important. Small curves are defined as curves that are between 10-20 degrees.
  • Mobilization of the affected facet joints; articulation.
  • HVLAT of the affected facet joints.
  • You constantly keep an eye on whether the curve is deteriorating. If the curve changes to between 20-40 degrees, a thoracolumbosacral brace (TLSO brace) is usually recommended, which keeps the back as upright as possible during the growth period. The principle is almost like when a houseplant is tied up on a bamboo stick, so as not to grow crooked. The TLSO brace is most effective if you wear it constantly, but otherwise at least at night.
  • If the curve changes to between 30-35 degrees, most people start to have escalating back pain, the disc wears asymmetrically and you can have problems with heart and lung function, and you are considering here if surgery is needed to relieve the patient. In cases where the curve is 40-45 degrees or greater, surgery is usually unavoidable. But it is a large and complicated operation that most people take months to recover from. Therefore, it is important to put time into training and treatment.
Rehab of the injury

Easy-moderate (8-15 year old) – Moderate-hard (12år+)