Scoliosis cannot be corrected by learning to sit or stand up straight. Food or vitamin supplements and exercise programmes have also shown no significant value in treating the condition. Although about 10% of all male and female adolescents suffer from scoliosis, less than 1% have curves that require medical attention. Scoliosis can be mild, moderate or severe. Treatment may include one or a combination of the following:
Observation
This non-surgical treatment of scoliosis involves observing the deformity with regular examinations and follow-up x-rays. Curves that are less than 25 degrees can be observed at four to six-month intervals. A growing child who has a curve greater than 25 degrees will require treatment. A brace may be used to treat progressive curves or curves more than 25 degrees.
Bracing
Bracing is designed to stop the progression of the spinal curve but does not reduce the amount of angulation already present. Thoraco-lumbar-sacral orthosis (TLSO) is one of the more commonly used scoliosis braces. Spinal bracing is recommended for growing children with progressive curves. Surgery is recommended when the curves are large.
Surgery
Surgery is recommended for curves greater than 40 degrees in children and for curves greater than 50 degrees at any age. It is a common misconception that scoliosis does not progress after skeletal maturity. It has now been shown that if left untreated, large idiopathic curves above 50 degrees will continue progressing in adulthood.
Surgical treatment of scoliosis may be indicated for any of these reasons:
- To prevent further progression of the curve
- To control the curve when brace treatment is unsuccessful
- To improve an undesired cosmetic appearance
- For reasons of discomfort or postural fatigue
The most common surgical treatment for scoliosis is spinal fusion using special stainless steel/titanium rods, hooks, screws and bone graft to carefully straighten the curved portion of the spine. In suitable patients, the surgery can be achieved through thoracoscopic "keyhole" techniques that require only four to five small openings on the side of the chest. Using modern spinal instrumentation, scoliosis patients who have undergone surgery lead normal and independent lives and can participate in most or all forms of sports. However, during the initial few months post-surgery, patients are advised to gradually ease into physical activities.
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