Treatment for Scoliosis
Treatment for scoliosis depends on the age and overall health of the child, the degree of the curvature, the underlying cause, and the risk for progression. Types of scoliosis treatment include observation, back bracing, and surgery.
Idiopathic scoliosis that measures less than 20 degrees usually resolves without treatment. This condition is monitored regularly (e.g., every 6 months) to make sure that it is not worsening (progressing).
Curvatures of the spine that show progression upon x-rays and curvatures between 20 and 40 degrees in a child who is still growing usually require a back brace. Children who require treatment for scoliosis often are referred to an orthopaedist (physician that specializes in conditions that affect the skeletal system).
Back braces to treat scoliosis are fitted to the child and may be custom-made. The type of brace used (e.g., Milwaukee brace, thoracolumbosacral orthosis [TLSO]) depends on the specific curvature. The child must wear the brace every day, for the amount of time prescribed by the orthopaedist, until he or she is no longer growing.
Severe scoliosis (i.e., 40 degree curvature) often continues to worsen and usually does not respond to bracing. If complications, such as impaired lung function, damage to the spine, or severe deformity develop, or if the condition progresses to 60 degrees or more, surgery may be necessary.
Surgery to correct severe scoliosis is called spinal fusion. In this procedure, a small piece of bone from another part of the body (called a bone graft) is used to connect two or more vertebrae. Surgical rods, hooks, or screws may be implanted during the procedure to keep the bone graft in place.
Over time, the vertebrae fuse together (i.e., become connected). Following spinal fusion surgery, children must restrict activities to allow the fused vertebrae to become solid.