Scoliosis Surgery and Treatment
Everyone has some degree of curvature in their backs, but at what point does the curve cause concern? The normal human spine curves gracefully in a gentle S from the neck to the pelvis, a complex structure of singular beauty, intricately designed for support, mobility and strength. But for unknown reasons, approximately 10 percent of adolescents develop some curvature in the middle or lower back.
Curves that spontaneously halt their progression at 10 degrees or less are considered normal and do not require scoliosis treatment. When they progress with no underlying cause, they're diagnosed as adolescent idiopathic scoliosis (AIS). Telltale signs of scoliosis include uneven shoulders, an elevated hip, a protruding scapula or a hump in the back when children bend forward. But often scoliosis exhibits no visible signs, making diagnosis difficult without radiographic studies.
Evaluation and Treatment of Adolescent Idiopathic Scoliosis
Screening for scoliosis focuses on evaluation of trunk symmetry using the Adams forward bend test. Physicians who suspect scoliosis will order a standing posterior-anterior thoraco-lumbar spine X-ray on a single long film. Additional studies, including a standing side According to the Scoliosis Research Society, neither exercise nor chiropractic manipulation have been clinically documented in the management of scoliosis.
|Less than 25 degrees||Periodic exams to detect progression|
|25 to 45 degrees in the thoracic spine||Brace wear|
|25 to 40 degrees in the lumbar spine||Brace wear|
|Greater than 50 degrees||Surgical correction |
According to the Scoliosis Research Society, neither exercise nor chiropractic manipulation have been clinically documented in the management of scoliosis.
For patients who are still growing, observation is the protocol when the curve is between 11 and 25 degrees. Bracing is the protocol when it is between 25 and 45 degrees. No treatment is necessary for patients who have finished growing, determined by an X-ray of growth plates, and who have a curve of less than 45 degrees. When curve magnitude reaches 45 to 50 degrees or greater in previously untreated patients or in patients who have failed to show improvement with orthosis, surgical correction is recommended for scoliosis treatment.