Adolescent Idiopathic Scoliosis

Overview  |  Concerns for Teens  |   Conservative Treatment  |  Surgical Correction

Conservative Treatment Options

  For simplicity and patient education, we break down scoliosis into three levels of severity.

  SMALL CURVES: 10-25 degrees. These patients are treated with observation. For teens still growing, follow-up x-rays are needed every 4 months until growth stops.

  MEDIUM CURVES: 26-40 degrees. If the patient is still growing, a brace should be considered. We use a custom molded TLSO (thoraco-lumbo-sacral orthosis) for most patients and our success rates have been similar to the national experience. The brace is about 70% successful at preventing curve progression. Nearly one third of patients that wear the brace experience curve progression anyway. The brace does not make the curve improve or go away. Successful bracing means that the patient avoids surgery because the curve does not increase. Successful bracing keeps the curve at the same degree it was when bracing was started.

   Certain types of braces (TLSO, Boston, Milwaukee, and Charleston have been studied by members of the Scoliosis Research Society and are successful in treating scoliosis. Some other types of braces have been widely advertised by their entrepreneur developers but their use is not supported by adequate data. If you have any questions about whether your brace is adequate, contact the Scoliosis Research Society or a SRS member in your area.

Treatments which have NOT been shown to have any affect on curve progression:
 — physical therapy
 — exercise program,
 — chiropractic manipulation,
 — medications
 — electrical muscle stimulation
 — certain types of braces
 — back packs
A TLSO type brace is the only form of conservative care shown to affect the progression of scoliosis when compared to no treatment at all.

  LARGE CURVES: 45 degrees and higher. These patients have a large enough deformity to warrant surgery in many cases. Remember that bracing does not improve a curve. It only prevents the curve from getting larger, if it works. Wearing a brace is a less attractive option for severe curves since the curve will still be large at the conclusion of treatment. For this reason, bracing is usually not an option for these patients. Without surgery, progression of these large curves during adulthood still remains a risk.

Overview  |  Concerns for Teens  |   Conservative Treatment  |  Surgical Correction