Your doctor will consider several things when planning your child's treatment:
- The location of the curve
- The severity of the curve
- Your child's age
- The number of remaining growing years — once an adolescent is fully grown, it is not common for a curve to rapidly worsen.
By evaluating these factors, your doctor will determine how likely it is that your child's curve will worsen and be able to suggest the best treatment option.
How is scoliosis treated without surgery?
- Observation. If your child's spinal curve is less than 25° or if he or she is almost full grown, your doctor may recommend simply monitoring the curve to make sure it does not get worse. Your doctor will recheck your child about every 6 to 12 months and schedule follow-up x-rays until your child is fully grown.
- Bracing. If the spinal curve is between 25° and 45° and your child is still growing, your doctor may recommend bracing. Although bracing will not straighten an existing curve, it often prevents it from getting worse to the point of requiring surgery.
In a recent research study of scoliosis patients with curves at a high risk for worsening, bracing significantly decreased the incidence of curves that progressed to the point of needing surgery.
There are several types of braces for scoliosis. Most of them are underarm braces that are custom-made to fit your child's body comfortably. Your doctor will recommend the type that best meets your child's needs and will determine how long the brace should be worn each day. Your child can take off the brace for sports activities.
How is scoliosis treated with surgery?
Your doctor may recommend surgery if your child's curve is greater than 45°-50° or if bracing did not stop the curve from reaching this point. Severe curves that are not treated could eventually worsen to the point where they affect lung function.
A surgical procedure called "spinal fusion" will significantly straighten the curve and then fuse the vertebrae together so that they heal into a single, solid bone. This will stop growth completely in the part of the spine affected by scoliosis.
During the procedure, the spinal bones that make up the curve are realigned. Small pieces of bone — called bone graft — are placed into the spaces between the vertebrae to be fused. Over time, the bones grows together — similar to when a broken bone heals. Metal rods are typically used to hold the bones in place until the fusion happens. The rods are attached to the spine by hooks, screws, and/or wires.
Exactly how much of the spine is fused depends upon your child's curve(s). Only the curved vertebrae are fused together. The other bones of the spine remain able to move and assist in motion.
Is spinal fusion for scoliosis successful?
Spinal fusion is very successful in stopping the curve from getting worse. Surgery is also able to straighten the curve significantly, which improves the patient's appearance.
Most children can return to sporting activities within 6 to 9 months after surgery. Because surgery causes permanent limitation of some spine movements, however, they should not participate in contact sports, like football. Spinal fusion does not increase the risk of complications during girls' future pregnancies or deliveries