Adolescent Idiopathic Scoliosis: Diagnosis and Conservative Management

• Autor(a) principal: Prado Costa, Rui; Serviço de Medicina Física e de Reabilitação do Centro Hospitalar São João
• Data de Publicação: 2020
• Outros Autores: Silva, Ana Isabel; Serviço de Medicina Física e de Reabilitação do Centro Hospitalar São João
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25759/spmfr.302
• topic: Adolescent; Braces; Scoliosis/diagnosis; Scoliosis/diagnostic imaging; Scoliosis/rehabilitation; Scoliosis/therapy; Adolescente; Braquetes; Escoliose/ diagnóstico; Escoliose/diagnóstico por imagem; Escoliose/ reabilitação; Escoliose/tratamento

Adolescent idiopathic scoliosis (AIS) is defined as three- dimensional deformation of the spine with a lateral curvature on the frontal plane greater than 10° and age of onset greater than 10 years, with no underlying etiology. The clinical assessment requires the exclusion of other etiologies. Management of AIS is determined according to the magnitude of the curve and remaining growth potential. The main goals of the conservative management are the control of curve progression, prevention of future complications, improve aesthetic appearance and quality of life. Orthotic management (bracing) of scoliosis, particularly rigid braces, has greater scientific evidence in AIS compared to other conservative strategies. There is a dose-response effect in bracing and non-adherence to the treatment is the main cause for loss of effectiveness which demands an appropriate monitoring. Electronic monitoring with compliance sensors applied on braces is an effective strategy for AIS monitoring. Scoliosis-specific exercises have some evidence in AIS, but in lesser degree compared to bracing, and can be used as an individual strategy or as a complement of bracing. The Schroth method and the Scientific Exercise Approach to Scoliosis accounts more evidence supporting better control of AIS. Management of AIS is complex and therefore it requires an individualized and integrative approach with multidisciplinary teams based on the current recommendations and scientific evidence which are highlighted throughout this work as well as some innovations in study.