Treatment Overview

The goal of treatment for scoliosis is to prevent the spinal curve from getting worse and to correct or stabilize a severe spinal curve. Fortunately, few people who have spinal curves require treatment.

The type of treatment depends on the cause of scoliosis. Scoliosis that is caused by another condition (nonstructural scoliosis) usually improves when the condition, such as muscle spasms or a difference in leg length, is treated. Scoliosis that is caused by a disease or by an unknown factor (structural scoliosis) is more likely than nonstructural scoliosis to need treatment.

• Nonsurgical treatment. This includes either routine exams by a doctor to check for any curve progression or the use of a brace to stop a spinal curve from getting worse. Children typically have these check-ups about every 4 to 6 months. Adults are usually checked about once each year.
• Surgical treatment. Surgery can be used to insert implants to hold the spine in place or fuse the spine together so that the curve cannot get worse.

Treatment is based on the age of the person, the size of the curve, and the risk of progression. The risk of progression is based on age at diagnosis, the size of the curve (as measured using X-rays of the spine), and skeletal age (which can be determined by the Risser sign).

• Mild curves are usually checked by the doctor every 4 to 6 months until the bones stop growing, to be sure the curves are not getting worse.
• Moderate curves may need to be braced until the bones stop growing, to keep the curves from getting worse.
• Severe curves or moderate curves that are getting worse may need surgery.

What to think about

Most cases of scoliosis are mild and do not require treatment.

The timing of surgery for scoliosis in children is controversial. Spinal fusion stops the growth of the fused part of the spine, so some experts believe that surgery should be delayed until the child is at least 10 years old and preferably 12. But even after surgery the rest of the spine will continue to grow normally in children who are still growing.