Management of scoliosis

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Management of Scoliosis

Scoliosis is a medical condition characterized by a sideways curvature of the spine, often diagnosed in childhood or adolescence. The management of scoliosis is multifaceted, involving observation, non-surgical interventions, and surgical procedures, depending on the severity and progression of the curve, the age of the patient, and the presence of symptoms. This article outlines the various approaches to managing scoliosis, highlighting the importance of individualized treatment plans.

Observation[edit | edit source]

For individuals with mild scoliosis (curves less than 20 degrees) and no signs of progression, observation is often the recommended approach. Regular follow-up appointments with a orthopedic specialist are necessary to monitor the curvature of the spine over time, typically through X-rays.

Non-surgical Interventions[edit | edit source]

Bracing[edit | edit source]

In cases where the spinal curve is between 20 and 40 degrees, especially in growing children and adolescents, bracing is a common non-surgical treatment option. The goal of bracing is not to correct the curve but to prevent further progression. The most commonly used braces include the Boston brace and the Milwaukee brace.

Physical Therapy[edit | edit source]

Physical therapy plays a crucial role in managing scoliosis, focusing on strengthening the muscles around the spine, improving posture, and in some cases, potentially slowing the progression of the curve. Specific exercises may be recommended based on the individual's condition.

Surgical Interventions[edit | edit source]

Surgery may be considered for individuals with severe scoliosis (curves greater than 40-45 degrees) or for those whose curves are progressing rapidly. The primary surgical procedures include:

Spinal Fusion[edit | edit source]

The most common surgical procedure for scoliosis is Spinal fusion, which involves joining two or more vertebrae together to prevent further curvature. This procedure can significantly reduce the degree of the curve and prevent further progression.

Vertebral Body Tethering (VBT)[edit | edit source]

VBT is a less invasive surgical option that involves placing screws in the vertebrae on the convex side of the curve and connecting them with a flexible cord. This method allows for some correction of the curve while maintaining spine flexibility.

Postoperative Care[edit | edit source]

Postoperative care is crucial for recovery and includes pain management, physical therapy, and regular follow-up appointments to monitor healing and spine alignment.

Conclusion[edit | edit source]

The management of scoliosis requires a personalized approach, taking into account the severity of the curve, the age of the patient, and the presence of symptoms. Through a combination of observation, non-surgical interventions, and surgical procedures, individuals with scoliosis can lead healthy, active lives.

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Contributors: Prab R. Tumpati, MD