Scoliosis

Alternative names:

kyphoscoliosis

Treatment:

The treatment is determined by the extent of the deformity and the stage of bone growth (how near the growth centers are to closure). Many scoliotic curves require no treatment (less than 30 degrees) but should be followed in 6-month intervals. Alternatives include observation, exercise, a back brace, surgery, or a combination of alternatives. The treatment is most successful when it is started early.

Exercises to strengthen torso muscles may prevent curve progression in mild cases (a curve of less than 30 degrees).

The Milwaukee brace or body shells are effective in controlling progression of the scoliosis but must be worn for long periods of time. A back brace does not reverse the curve. The spine is strengthened by the brace from asymmetric pressure, and can be adjusted with growth. The brace is usually worn until bone growth has stopped in late adolescence. A spinal curve of 30 to 50 degrees can be managed with a brace and exercises.

A spinal curvature of 40 degrees or greater usually requires surgery to correct the curvature since curvature to this degree progresses even after bone growth stops. Surgical procedures include placement of a metal rod (Harrington rod) that prevents progression of the curvature but restricts spinal mobility. A brace may be required after surgery to stabilize the spine.

The limitations imposed by the treatments are often emotionally difficult and may threaten self-image, especially of teenagers. Emotional support is important for adjustment to the limitations of treatment. Physical therapists and orthotists (orthopedic appliance specialists) can be helpful in explaining the treatments and ensuring a comfortable fit of the brace to increase the compliance with the treatment plan.

Support groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See scoliosis - support group.

Expectations (prognosis):

The outcome depends on the location and severity of the curve. The greater the curve, the greater the chance of progression after growth has stopped. Untreated scoliosis may result in heart and lung problems due to decreased lung capacity, back pain, physical deformity, degenerative arthritis of the spine, and sciatica.

Complications:

Emotional problems or lowered self-esteem may occur as a result of the condition or its treatment.

Calling your health care provider:

Call for an appointment with your child's health care provider if you suspect that he or she may have scoliosis.