Rapid, Spontaneous Resolution of Adolescent Idiopathic Scoliosis
1Medical Student, Texas A&M College of Medicine, Bryan, TX
2Pediatrician, Kelsey-Seybold Clinic, Houston, TX
Moser J, Bourland A, Byrd R. Rapid spontaneous resolution of adolescent idiopathic scoliosis. Consultant. 2023;63(3):e1. doi:10.25270/con.2022.07.00007
Received October 8, 2021. Accepted October 25, 2021. Published online July 11, 2022
The authors report no relevant financial relationships. Written informed consent for use of the images contained in this article was obtained from both the patient and his parent.
Richard Byrd, MD, Kelsey-Seybold Clinic, 7010 Highway 6, Missouri City, TX 77459 (Richard.firstname.lastname@example.org)
Adolescent idiopathic scoliosis (AIS) is defined as a more than 10-degree lateral curve of the skeletal spine seen on standing radiograph in children aged 11 to 18 years with unknown etiology. Treatment of AIS is determined by the patient’s Cobb angle and skeletal maturity. Treatment options include observation, exercise therapy, bracing, and surgery, with surgery being the only proven treatment to correct scoliosis. We present a case of a 13-year-old boy with AIS with a left thoracolumbar curve of 23.7-degrees that resolved spontaneously in less than 4 months with exercise and physical therapy.
Key words: adolescent idiopathic scoliosis, scoliosis, spinal curvature
Idiopathic scoliosis in adolescents is a relatively common spine deformity of unknown etiology. Although mild curvatures have been known to fully resolve over time, more significant curves rarely do so. We present a case of moderate scoliosis (23.7-degree left thoracolumbar) that resolved spontaneously in less than 4 months, with exercise and physical therapy as the sole treatment modalities.
A 13-year-old, right-handed, adolescent male presented to his pediatrician for his annual health maintenance examination with no chief complaint. His medical history was significant for moderate persistent asthma well-controlled with inhaled fluticasone-salmeterol. He is a year-round student-athlete, and he does not report significant pain.
On physical examination, a 6-degree left lumbar rib hump (on Adam's forward bend test) was found using a Scoliometer™. Asymmetry of the back while standing was observed (Figure 1).
Figure 1. Asymmetry of back in standing position at time of diagnosis
Diagnostic testing. A standing posteroanterior scoliosis radiograph demonstrated a left thoracolumbar curve from T6-L3 with a Cobb angle of 23.7 degrees and a Risser grade of 0. A lateral spine showed no evidence of spondylolisthesis. A concomitant left hand/wrist film showed a bone age of 13 years, equivalent to his chronological age (Figures 2A-2C).