scolisosis vs normal curve of spine

Scoliosis Treatment Options

Scoliosis is an abnormal curve in the spine to either side of the body where the spinal bones form a “C” or “S” shape in the spine.  The diagnosis of Scoliosis is done by a specialized doctor through physical tests and imaging equipment and techniques: X-rays, CT scans or MRI.

There are three scoliosis treatment options depending on the severity of the spinal curvature and the unique circumstances of the patient: observation, bracing or scoliosis surgery.  There are other factors involved when considering the proper treatment for scoliosis that we’ll discuss below.

Our South Florida specialists at Spine & Orthopedic Center, lead by Dr. Ashish Sahai, are nationally recognized for the treatment of scoliosis. Our patients can schedule a visit in any of our 4 locations throughout Broward and Palm Beach county.

Recommendations for Treatment of Scoliosis

It is worth mentioning that 90% of scoliosis cases are moderate and do not require any type of treatment or intervention, expect for recurring observation by a doctor every 4 to 6 months (in most cases) until the patient reaches his/her full skeletal growth.

If the curves in the spine are big and growing rapidly, bracing is often recommended.  As a matter of fact, the use of braces for scoliosis is the most recommended treatment.  Spine surgery for Scoliosis is the last resort and only recommended if bracing is not effective after prudent observation.

Several people claim that physical therapy and/or manual manipulation can help restraining the progression of the curve; but, as of now, there is little to none scientific proof to back up these claims. On the other hand, your doctor may recommend exercise to keep the back flexible and strong.

Factors to determine proper treatment

  • Patient age and gender
  • Bone maturation
  • Location of the curve in the spine
  • Degree of the curvature
  • Progression of curvature
  • Related symptoms: back pain, shortness of breath, others

Bracing

Bracing is the only non-surgical treatment option proven to reduce the progression of a scoliotic curve.  A spine curve brace is frequently prescribed by most physicians as a first treatment option.  Back braces customized for the specific curvature of the patient’s scoliosis are used to attempt to restrain the curve during the growth years.

Common Type of Braces For Scoliosis

The most common type of brace is made of plastic and is designed to adjust to the body.  This close-fitting brace is practically invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips.  A brace’s efficiency increases with the number of hours that it’s worn.  Most braces are worn all day long or at nights only:

  • All-Day bracing – Designed to be worn 16 to 23 hours a day.  The intention is to wear them all the time with exceptions for bathing, skin care, and exercising.
  • Night bracing – Put the body out of normal balance and cannot realistically be applied while a person is standing and/or performing day-to-day activities.  It is meant to be worn at least 8 hours per night.

Scoliosis Surgery: Instrumentation and Fusion

If the patient’s scoliotic curve meets certain criteria, and the bracing treatment didn’t help improving or delaying the condition, a spine surgery procedure may be prescribed.  Spinal Fusion is a surgical procedure where two or more adjacent vertebrae are fused, thus forming a solid bone that no longer moves.

Spinal Fusion is performed through the insertion of pedicle screws and hooks at various points in the spine in conjunction with rods in order to straighten the spine curve.  The rods are then locked in position and a bone graft is applied to create a fusion, to prevent further curve progression.

Combining fusion and instrumentation has really achieved better results than before with a better curvature correction and much faster recovery times.

Main Objectives of Scoliosis Surgery

  • Stop the scoliotic curve progression.
  • Reduce the spine deformity.
  • Maintain balance.

What happens if I decide not to be treated?

There are two factors that can strongly predict whether a scoliosis curve will get worse: young age and a larger curve at the time of diagnosis. Children younger than 10 years old with curves greater than 35 degrees tend to get even worse without treatment. Once a person has reached bone grown maturity, it is less likely for a curve to progress at a fast rate.

Several studies suggest that once someone reaches growth maturity with a scoliotic curve less than 30 degrees, the conditions doesn’t get worse in most cases; while those with scoliotic curvatures greater than 50 degrees can get worse over time, by about 1 to 1 1/2 degrees per year.

For further information regarding possible treatments for scoliosis, it is always best to discuss it with your primary care doctor or an orthopedic specialist.  Feel free to call us 24/7 and request an appointment with one of our Scoliosis Specialists at 888-409-8006.