A narrative review of the clinical characteristics, diagnosis, and treatment options for adolescent idiopathic scoliosis (AIS)

Abstract

This narrative review was conducted to consolidate and analyze current evidence on the clinical characteristics, diagnostic methods, and treatment approaches for adolescent idiopathic scoliosis (AIS). AIS typically presented between the ages of 10 and 18 years and affected approximately 2–4% of adolescents, with a higher prevalence among females. The risk of curve progression increased during rapid skeletal growth and was influenced by age at diagnosis, initial Cobb angle, and skeletal maturity. Diagnosis relied on clinical evaluation, including the Adam’s forward bend test and confirmed via radiographic imaging using Cobb angle measurement. MRI/CT was utilized in atypical presentations to rule out intraspinal lesions. Treatments included observation for mild curves, bracing for moderate curves (20°–40°), and surgery for those with significant curves (usually >45°). The Schroth method and other exercise prescriptions were used as adjuncts to bracing. Vertebral body tethering (VBT) was being utilized as a motion-sparing alternative to spinal fusion for scoliosis curves. Pharmacological treatment was still limited to pain management. The psychosocial impacts for body image disturbance and anxiety were distinct especially for braced and surgically treated patients. Emerging themes included 3D-printed orthoses, AI predictive modeling, and genetic profiling. There remained significant identified gaps in the evidence base, particularly around long-term outcome measures, especially in comparing surgical and conservative care strategies to manage scoliosis.