Scoliosis
Treatment Overview
The goal of treatment for scoliosis is to prevent the spinal curve from getting worse and to correct or stabilize a severe spinal curve. Fortunately, less than 10% of people who have spinal curves of more than 10 degrees require treatment.9
The type of treatment depends on the cause of scoliosis. Scoliosis that is caused by an underlying condition (nonstructural scoliosis) usually improves when the underlying condition, such as muscle spasms or a difference in leg length, is treated. Scoliosis that is caused by a disease or by an unknown factor (structural scoliosis) is more likely to need treatment than nonstructural scoliosis.
- Nonsurgical treatment. This includes either regular observation by a doctor about every 4 to 6 months to check for any curve progression or the use of a brace to stop a spinal curve from getting worse.
- Surgical treatment. Surgery can be used to insert implants to hold the spine in place or fuse the spine together so that the curve cannot get worse.
Treatment is based on the age of the person, the size of the curve, and the risk of progression. The risk of progression is based on age at diagnosis, the size of the curve (as measured using X-rays of the spine), and skeletal age (which can be determined by the Risser sign).
Treatment for a child, whose skeleton is not fully grown, may include the following:
- If the curve is less than 25 degrees, regular observation by a doctor may be done to check for any progression in the curve. Often, no further treatment is needed.
- If the curve is between 25 and 40 degrees, a brace may be used to prevent the curve from progressing as the child grows. Some doctors may use brace treatment for curves up to 45 degrees. Brace treatment is usually continued until the skeleton stops growing.
- If the curve is more than 40 degrees, bracing may not be effective.
- Surgery may be considered if the curve is more than 50 degrees. Without surgery, this large curve is likely to get worse.
Treatment for an adult, whose skeleton is fully grown, may include the following:
- Pain relievers, such as aspirin and similar drugs, and regular exercise may be enough to relieve back pain.
- If the curve is less than 50 degrees, regular observation by a doctor may be done to check for any progression in the curve.
- If the curve is greater than 50 degrees and is getting worse, surgery may be considered.
What To Think About
Most cases of scoliosis are mild and do not require treatment.
The timing of surgery for scoliosis in children is controversial. Some experts believe that surgery should be delayed until the child is at least 10 years old and preferably 12 because spinal fusion stops the growth of the fused part of the spine. However, the rest of the spine will continue to grow normally.
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| Author: | Kathe Gallagher, MSW | Last Updated: August 30, 2007 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Thomas S. Renshaw, MD - Orthopedics | |
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