Idiopathic Scoliosis

Treatment
Observations:
For smaller curves (under 25-30 degrees), we typically observe the patients with long-cassette xrays every 6 months.

Bracing:
When curves reach 25-30 degrees, we consider bracing in patients with 2 or more years of growth remaining. The brace is custom molded for each patient, and can be removed for sports. The goal of the brace is to even out the stresses on the vertebral endplates so they will grow straight as opposed to on an angle.

Surgery:
Surgery is typically recommended:

1. With curves over 45 degrees (and the patient is still growing),
2. In curves over 45 degrees that are tender after skeletal maturity;
3. In curves over 45 degrees that remain tender after maximizing conservative management.

For more information, read Dr. Rinella’s article on Fusion Levels in Adolescent Idiopathic Scoliosis.

Idiopathic scoliosis is the most common form of scoliosis. “Idiopathic” means we do not really understand why it happens. It can happen very early in life, but is most common during adolescence when children are growing the most. Although scoliosis is equally common in boys and girls, larger curves are much more common in females. Children and adolescents with scoliosis typically are otherwise healthy.

Diagnosis
The vast majority of children will never require any type of treatment for their scoliosis. However, it is important to monitor the curves with xrays until approximately 15 years of age in girls, and 18 years of age in boys. When curves reach 25-30 degrees, we consider bracing. Surgery may be indicated in curves over 40-45 degrees.