Scoliosis is a sideways curvature of the spine, and the treatments for it can be somewhat different for children and adults. The following are some treatments for both kinds of patients.
Children with Scoliosis. The treatment for a child with scoliosis depends on where the curve is in the spine, how severe it is and the age of the child. It also depends on how many more years they have until they stop growing. In some cases, the curvature of the spine is so slight that no treatment at all is needed. If the curvature is less than 25 degrees and the child has nearly completed their growth, the chiropractor may just monitor the spine. They’ll take X-rays every six months to a year to make sure that the curvature doesn’t get worse. Curvatures of the spine rarely get worse after the patient has stopped growing.
Braces. A curvature that’s from 25 to 45 degrees in a child who’s still growing can be corrected with a back brace. The brace doesn’t straighten the spine but prevents the curvature from growing worse. Braces for scoliosis are made specifically for the child. The most common looks rather like an old fashioned corset and is called the Boston brace. It is a kind of thoracic-lumbar-sacral orthosis brace.
Another type of brace for scoliosis is the Wilmington brace. It differs from the Boston brace because it is made from a cast of the patient while they’re lying face-up, and unlike the Boston brace it does not have open areas. The Milwaukee brace was used mostly during the 1940s. It is bulkier and less comfortable to wear than the other two braces, but some patients with curves in the middle of their back or their neck still wear them.
If a child’s spine has a curvature of more the 45 to 50 degrees, or if wearing a brace didn’t stop the curvature from getting worse, surgery may be needed. Severe curves may start to cause symptoms and can even affect the child’s ability to breathe properly.
Spinal fusion is used to straighten out the spine and fuse two or more vertebrae together so they heal into one solid, immobile bone. The surgeon uses bone grafts that are often taken from the patient to create the fusion, and the grafts and the vertebrae are stabilized with metal rods that are secured by hooks, wires or screws. The surgeon only fuses together the vertebrae that were part of the abnormal curvature, and the rest of the bones in the child’s spine can move normally.
The patient should be up and walking about two days after their surgery. Most are discharged after a week in the hospital, able to resume their regular schedule after about a month and can return to playing their favorite sports after six to nine months. Girls who have had the surgery should not worry about future pregnancy complications.
Adults With Scoliosis
As with children, most cases of adult scoliosis are mild and do not need treatment. However, in adults, the type of treatment doesn’t depend on the degree of the curvature. The treatment occurs when the adult patient starts to feel pain, and they are treated like other patients who have back pain. Unlike children and adolescents, whose scoliosis is most often found around the middle of the back, adult scoliosis is mostly found in the lower back and is a consequence of aging.
Most cases of adult scoliosis can be treated conservatively. The chiropractor monitors the curvature and helps the patient strengthen the muscles of their back and abdomen. This can be done through massage and gentle exercises such as swimming and stretching, and simplify staying active. If the patient smokes, it is imperative that they quit. As with every other aspect of health, smoking makes scoliosis worse.
If the scoliosis doesn’t respond to this treatment, the doctor may give the patient a nerve block or epidural injections to ease the pain.
If other treatments fail, surgery is an option in adult scoliosis. It is recommended if the patient has intractable pain, if their spine is badly imbalanced or if the scoliosis is interfering with the patient’s quality of life. As with children, spinal fusion is a surgery that is used to resolve cases of adult scoliosis.