Spine Disorders
TREATMENT OPTIONS The choice of treatment for scoliosis is
based on the patient’s age, the severity of the curvature and underlying cause
and contributing factors for the scoliosis. Certain types of scoliosis have a
greater likelihood of progressing. There are five primary categories of care
which are observation, bracing, spinal manipulation, corrective active motion
traction, exercise and postural training and surgery. A functional scoliosis is generally
caused by an abnormality outside the spine. The most common causes are leg
length inequality and muscular imbalances. This type of scoliosis is best cared
for by treating the non-spinal cause. Neuromuscular scoliosis is caused by a
disease process, which results in impaired muscular control and stability of
the spine. These types of scoliosis are usually very progressive. Observation
and bracing by themselves are usually not good treatment options. The majority
of patients with a neuromuscular scoliosis require care of the underlying
neuromuscular condition. Some will eventually require surgery to stop the curve
from getting worse. In most cases, infantile idiopathic
scoliosis will improve without any specific form of treatment. Follow up X-ray
studies may be performed on a periodic basis to help determine if the scoliosis
is progressive. Bracing is not usually effective for this form of scoliosis. Juvenile onset idiopathic scoliosis has
the highest risk for progressing when compared to the other forms of idiopathic
types of scoliosis. Bracing may be implemented early during the course of care.
The primary goal of early intervention is to prevent the curve from getting
worse until the patient stops growing. Juvenile scoliosis development usually
starts fairly early and therefore there is a long period of growth during which
time the curvature can progressive in severity. Subsequently there is a higher
likelihood of requiring aggressive treatment and/or surgery. |