There are currently three recommended treatments and preventions for scoliosis dependent on factors of the affected individual (age, type, maturity, and curve degree).
For curves measuring less than 25 degrees, regular checkups are recommended especially if the individual is still growing. A suggested time schedule is a checkup with a medical professional every 4 to six months. These checkups include a physical exam along with a possible low-radiation x-ray to reaffirm the degree of curvature.
For curves measuring between 25-40 degrees a bracing treatment is highly recommended in patients whose bones are still developing. This type of treatment only prevents the curve from worsening, overall preventing the need for surgery. However, it does not correct the curve. Most braces are required to be worn both during day and night. The brace can then be eliminated after the bones are confirmed to be done growing, or fusion of the growth plates has occurred.
There are two types of braces:
-An “underarm or low-profile” brace is contoured to form to an individual’s body. These braces are not useful for curves that are in the upper spine or neck.
-On the other hand, the “Milwaukee” brace is a full torso brace that contains a neck ring. These braces are usually only worn in situations where an underarm brace would not be sufficient help prevent the curve from worsening.
Overall, bracing appears to prevent about 20-40% of curves from progressing more than 6 degrees.
Cases with curves measuring close to or greater than 40 degrees are considered for surgical intervention. Scoliosis surgery has two goals: to prevent curve progression and to obtain some curve correction. “Scoliosis surgery is one of the most demanding surgical procedures in spine surgery.” Because of this, it is only considered in cases where there is continuous pain, difficulty breathing, significant disfigurement, or continued progression.
-The most common type of scoliosis surgery is called spinal fusion. This consists of joining the vertebrae together permanently. Pieces of bone or bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires hold the effected part of the spine straight while old and new bone materials fuse together.
To aid in the decision making as regards to treatment options, a study by Weinstein and Ponseti on “Curve Progression After Skeletal Maturity” was performed.
-The patients were evaluated as a group and by curve pattern (thoracic, lumbar, thoracolumbar, and combined).
-After following the patients for 40.5 years, results showed that “in general, curves that were less than 30 degrees at skeletal maturity tended not to progress regardless of their curve pattern.”
-On the other hand, curves measuring between 50 and 75 degrees at skeletal maturity were shown to progress, particularly thoracic curves.
For cases that progress rapidly at a young age, a new treatment method has recently been developed. Two adjusting rods with an external remote control can be surgically placed along the young patient’s spine. The rods can then be lengthened along with the child’s development every six months and prevent further curve progression.