Scoliosis - Treatment
Treatment & prognosis & Evidence/Road to recoveryTreatment may be simply to be assess, review and reassure if the curve is mild and non –progressive. The x-ray measurement of curve magnitude is done using the ‘Cobb’ angle.
A spinal curve after the age of 8 does not affect internal organs or restrict heart and lung function. Participation in fitness activities and sports should not be restricted at all. A curve in the spine is not a ‘weakness’ and should not be viewed as a disability.
In young people that are still growing the use of a spinal brace may reduce the possibility of the curve getting worse. A brace seems to be useful for modest curves of between 25 to 40 degrees. After spinal growth is complete the clinical effectiveness of a brace is low.
Spinal surgery is a very effective treatment for larger curves, the main advantage is an improvement in body shape and the knowledge that the curve will be stabilised after surgery. The surgery involved in scoliosis correction will vary according to the curve magnitude and the surgical specifics of the spinal curve. Most operations for scoliosis involve correcting the curve (within the limits of safety) and fusing the segment into one rigid bone. This is not a problem when the scoliosis just involves the chest area but can sometimes be a problem when the operation also involves the lower back (lumbar area). The risks of surgery should be carefully explained and balanced against the benefits of surgery. This process of consent is one of shared decision making between the doctor and the patient and family.