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How is Scoliosis Treated?

Observation

After scoliosis is diagnosed, any changes in the curvature should be regularly monitored by a scoliosis specialist. This is especially important in adolescents. X-Rays will need to be taken every 6 months or yearly to record the Cobb angle, which is the degree of the curvature. If the angle is small and does not increase, treatment might not be needed. A curvature of up to 11º is considered normal.

Bracing & Casting

If the angle of curvature is more than 25º, a specialist might recommend use of casting in infants and juveniles or a brace in adolescents. Casting is often used in early onset scoliosis to help encourage the spine to grow straight. The cast is made out of plaster-of-Paris and is worm permanently with regular monitoring. A brace cannot cure scoliosis (there is no such thing as a cure!) or straighten a curve, but it can stop a curve from getting worse. The most commonly used brace is known as the Boston brace. This is a lightweight brace that is designed to be unobtrusive and is practically impossible to see when worn under loose clothing. The brace will be carefully fitted and is based on a cast of the wearer's torso. The brace will usually be worn for a time frame set by your specialist, and should usually only be removed for baths and showers. It does not interfere with normal everyday activities and can be worn during most non-contact sports. This can be a difficult time for young people; support and reassurance from friends, family and support is crucial.

Surgery

In early onset scoliosis growth rods are sometimes used and are lengthened periodically to ensure the child's height is not restricted. In adolescents, if the scoliosis is severe, with a curvature of more than 50º, surgery might be recommended. Surgery can prevent damage to the heart and lungs, and help alleviate back pain and disability. Spinal fusion is a complicated technique, and therefore patients should be referred to a specialist unit for surgery. During surgery, the spine is straightened by the use of metal implants and bone grafts. After surgery, the patient will be transferred to a high dependency unit and will remain in hospital for a few days. After the operation, most patients will be able to return to school or work after 4-6 weeks. Your age at the time of surgery will dictate how quickly you will resume every day life. Most people will be able to participate in sporting and fitness activities after about a year. Some will need to wear a brace after the operation to support their spines.