Scoliosis (cont.)
How is scoliosis treated?
Treatment of scoliosis is based on the severity of the curve and the chances
of the curve getting worse. Certain types of scoliosis have a greater chance of
getting worse, so the type of scoliosis also helps to determine the proper
treatment. There are three main categories of treatment: observation, bracing,
and surgery.
Functional scoliosis is caused by an abnormality elsewhere in the body. This
type of scoliosis is treated by treating that abnormality, such as a difference
in leg length. There is no direct treatment of the spine because the spine is
normal in these people.
Neuromuscular scoliosis is caused by an abnormal development of the bones of
the spine. These types of scoliosis have the greatest chance for getting worse.
Observation and bracing do not normally work well for these people. The
majority of these people will eventually need surgery to stop the curve from
getting worse.
Treatment of idiopathic scoliosis is based on the age when it develops.
In many cases, infantile idiopathic scoliosis will improve without any
treatment. X-rays can be obtained and measurements compared on future visits to
determine if the curve is getting worse. Bracing is not normally effective in
these people.
Juvenile idiopathic scoliosis has the highest risk for getting worse of all
of the idiopathic types of scoliosis. Bracing can be tried early if the curve is
not very severe. The goal is to prevent the curve from getting worse until the
person stops growing. Since the curve starts early in these people, and they
have a lot of time left to grow, there is a higher chance for needing more
aggressive treatment or surgery.
Adolescent idiopathic scoliosis is the most common form of scoliosis. If the
curve is small when first diagnosed, it can be observed and followed with routine
X-rays and
measurements. If the curve stays below 25 degrees, no other treatment is needed.
If the curve is between 25-40 degrees, a brace may be recommended. If the curve
is greater than 40 degrees, then surgery may be recommended.
As explained above, scoliosis is not typically associated with back pain. In cases with back pain, the symptoms can be lessened with physical therapy, massage, and exercises, including yoga. These can help to strengthen the muscles of the back. They are not, however, a cure for scoliosis and will not be able to correct the abnormal curve.
There are several different types of braces available for scoliosis. Some
need to be worn nearly 24 hours a day and are removed only for showering. Others can
be worn only at night. The ability of a brace to work depends on the person
following the instructions from the doctor and wearing the brace as directed.
Braces are not designed to correct the curve. They are used to help slow or stop
the curve from getting worse.
If the curve stays below 40 degrees until the person is finished growing, it
is not likely to get worse later in life. However, if the curve is greater than
40 degrees, it is likely to continue to get worse by 1-2 degrees each year for
the rest of the person's life. If this is not prevented, the person will
eventually be at risk for heart or lung problems.
If a tumor such as osteoid osteoma is the cause of the scoliosis, surgery to remove the tumor is generally able to correct the curve.
People with degenerative scoliosis will often have more complaints of back and leg pain. This is related
to the arthritis in the back and possible compression of the nerve roots that lead to the legs. Nonoperative
treatment including physical therapy, exercises, and gentle chiropractic can
help relieve these symptoms in some cases. People who fail to improve with these treatments may benefit from surgery. X-rays and possible MRIs will be obtained to plan for surgery. The surgery could include only a decompression or removal of bone spurs that are compressing the nerves. In some cases, a fusion will be necessary to stabilize the spine and possibly correct the abnormal curve.
Next: What is the outlook for scoliosis? »
- Lower Back Pain - Get information on causes of lower back pain (arthritis, pregnancy, herniated disc, sciatica, spinal stenosis, endometriosis, ovarian cysts), includes back pain treatment and diagnosis.
- Marfan Syndrome - Read about Marfan syndrome, a hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
- Radiculopathy - Learn about radiculopathy, a condition caused by compression of a nerve in the spine. Symptoms include pain, numbness, tingling, or weakness along the nerve.
Latest Medical News
Kids Health RSS