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.