As with many medical conditions the earlier that scoliosis is diagnosed then the more effective and less drastic the treatments that are required to lessen the effect of it.
There are three main forms of treatment for scoliosis which are observation, bracing and surgery. Observation is the first and most vital because there are different forms of scoliosis which can progress in different ways this will determine the type of further treatment that will be required.
During observation the key factors are seeing how bad the curve of the spine is, assessing how much future growth there is in the patient as this can mean the curve can get worse and whether the form of scoliosis is functional or neuromuscular.
For functional scoliosis, treatment of the spine is not required as the spine is normal therefore, it is more about preventing the curve of the spine getting worse because of the abnormality elsewhere in their body putting it out of shape. Most commonly this is an uneven leg length which can be rectified with a wedge or platform being used on the shoe of the shorter leg to even up leg length when walking.
Bracing
In the case of neuromuscular scoliosis which is predominantly found in adolescents that are still growing then bracing may be used to stop it getting any worse. However, this only happens after a period of observation where measurements are taken at regular intervals to see how much the curve is progressing.
Sometimes the curve is only very mild and just requires observation, bracing will only be used if there are indications that the curve has reached a critical point between 25 and 40 degrees and is likely to progress without treatment.
If a brace is prescribed then it takes the form of a full body brace with the option of full time wear or night time wear dependent on the severity of the curve and practicality for the patient. The effectiveness of the brace is dependent on the patient adhering to correct management of it and it will need to be worn until growth has stopped. Observation will continue throughout the time that the brace is worn and if the curve remains below 40 degrees then it is unlikely that it will change after growth has stopped.
Surgery
Surgery is usually only required in cases where a person has already stopped growing or even after bracing the curve is above 40 degrees and it is done to prevent further curvature of the spine by fusing it. Spinal fusion involves rods and screws being fixed to the part of the spine with the curve and also bone grafts which will then fuse with the existing bone so it remains solid and stops any further movement. The rods and screws will not be removed but will remain in place to give a near normal spine alignment which can be maintained for the rest of the patients life.