Scoliosis - Treatment

A number of factors determine the kind of treatment for scoliosis. These factors include the amount of curvature, the likelihood of improvement, and the amount of pain that may be involved, if any.

Observation

A perfectly straight spine is said to have a curvature of 0 degrees. Children who have curvature of less than 20 degrees usually do not receive any form of treatment.

In many cases, the only medical attention required for scoliosis is careful observation over time. This observation allows doctors to decide whether some form of treatment may be necessary or not. Observation is usually used with adolescents whose spine has a curvature of 20 to 30 degrees. It is also used with adults with a curvature as high as 40 degrees, as long as there is no pain.

Bracing

In more serious cases of curvature, a procedure known as bracing may be used. Bracing is a method of treatment in which the upper body is held in position by metal rods. Three types of bracing are used for scoliosis:

• The Milwaukee brace consists of metal rods attached to pads at the hips, rib cage, and neck.
• The underarm brace uses rigid plastic to surround the lower rib cage, abdomen, and hips.
• The Charleston bending brace is used at night to bend the spine in the opposite direction.

Braces are usually worn for twenty-two to twenty-four hours each day. Bracing is used with children or adolescents whose curvature is greater than 30 degrees and who are expected to grow for at least another year.

The procedure cannot correct curvature that has already occurred. But it can help to prevent the problem from getting worse. Bracing is seldom used with adults. Two situations in which it may be used are with people who suffer great pain and those who cannot undergo surgery.

Surgery

Scoliosis can also be treated with surgery. Surgery is usually recommended under the following conditions:

• The curvature has progressed despite bracing.
• The curvature is greater than 40 to 50 degrees before growth has stopped in an adolescent.
• The curvature is greater than 50 degrees and continues to increase in an adult.
• The patient is in significant pain.

Surgery for neuromuscular surgery is often done earlier. The three goals of surgery are to correct the curvature as much as possible, to prevent further curvature, and to relieve pain. Surgery can usually correct 40 to 50 percent of the curvature, and sometimes as much as 80 percent. It is not always successful in completely removing pain.

The surgical procedure for scoliosis is called spinal fusion. The goal of this procedure is first to straighten the spine as much as possible. Then, the vertebrae are joined together to prevent further curvature.

The first step in spinal fusion is to uncover the vertebrae in the region of curvature. These vertebrae are then scraped clean to produce smooth surfaces. The vertebrae are then joined to each other. When joined in this way, the vertebrae eventually grow together. Metal rods are then inserted along the spine. The vertebrae are attached to the rods with hooks, screws, or wires. The rods hold the spine in position until the vertebrae grow together.

Spinal fusion leaves the involved section of the spine permanently stiff and inflexible. A person no longer has a full range of motion. However, most activities are usually not affected by this change. Normal mobility (movement), exercise, and even contact sports are possible after spinal fusion. Full recovery following spinal fusion takes about six months.

Alternative Treatment

Exercise may help relieve the pain of scoliosis. However, it has no effect on the overall development of the disorder. Good nutrition is also helpful in maintaining a healthy body. But nutrition also has no effect on the progression of scoliosis.

Chiropractic treatment can sometimes relieve the pain of scoliosis. But it does not stop or slow down the progress of the disorder. It also should not be used in place of standard medical treatments. Acupuncture and acupressure may also help reduce and pain and discomfort, but have no effect on the disorder itself.