ADOLESCENT SCOLIOSIS

  • Definition and cause


    Idiopathic scoliosis is a torsional deformity of the spine that often develops during pre-adolescence and that intensifies with growth.



  • Course of the disease


    Scoliosis is often diagnosed by family or the physician, in the presence of an S-shaped back. The curvature of the back tends to increase the most during puberty, and then stabilize at about 16-17 years of age. The risk is not immediate, but rather in adulthood, after age 40, when osteoarthritis and pain will begin, continuing until they become disabling.



  • Treatment options


    Treatment of adolescent scoliosis is highly standardized and decisions will be made based on the extent of the deformity, age, and the state of progress of puberty. Often, at the time of discovery, rehabilitation by the physical therapist is started to maintain the flexibility of the back. Then, based on the course of the disease, discussion will move to the need for use of a suitable removable plastic back brace, or surgery to correct the deformity, which is never carried out before the child has finished growing.



  • Principle of surgical treatment


    The aim of scoliosis surgery is to treat the deformity of the back, at the time when it can be best corrected, to avoid the onset 10 or 20 years later of unavoidable pain, which would then require more invasive surgery with a lower correction potential.



  • Average hospitalization time


    7 days (this is the duration most often reported).



  • Recovery time


    A 3-week stay at a rehabilitation center is often essential after discharge from the clinic. Transfer is by medical transport service. Management will be multidisciplinary (rehabilitation specialist, pain specialist, physical therapist, ergotherapist). The aim of the stay is to monitor the dressings, pain management, learn adapted actions for everyday life at “back school”, and recover sufficient autonomy to return home. The total recovery period is at least 3 to 6 months following the surgery. Based on the severity of symptoms before the procedure, this period may be longer. The back brace must be worn during the day for the first 3 months. Recovery is not synonymous with bed rest. Physical exertion, carrying loads, and car trips must be limited during this period. Walking is often beneficial. Recurrence of pain during recovery is often the result of too much activity and will tend to disappear with rest.