Treatment Variations in Adolescent Scoliosis

x-ray of spine experiencing scoliosis

Scoliosis describes a spine that is abnormally curved or twisted. Most commonly it occurs in either the thoracic or lumbar region of the spine. In the United States, scoliosis tends to first be identified in children around the age of puberty during a physical exam for school. Milder versions of scoliosis are detected in patients aged 50 or older. Adolescent scoliosis is detected between the ages of 11–18 years, accounting for approximately 90% of cases of idiopathic scoliosis in children. It is the most common spinal deformity in school-aged children. The number of children with scoliosis in the United States exceeds 4 million. Not all cases require treatment or surgery, but all should be monitored for progression. Fortunately, the expert staff at Centers for Neurosurgery, Spine & Orthopedics can offer their assistance.

Pain and disfigurement are the two most extreme common symptoms of scoliosis. Studies have shown that the incidence of low back pain is almost twice as high in people living with scoliosis as those without. Physical therapy can be an important treatment towards reducing pain and minimize deformity progression. Bracing is also beneficial. But if the degree of curvature becomes too severe, surgery is the primary treatment.

Bracing for Scoliosis

Bracing remains a standard in the treatment of care for idiopathic scoliosis in children. Bracing is typically initiated when the curvature of the spine measures 20 degrees or greater. Research indicates that scoliosis may rapidly worsen during adolescence, especially if the curve is greater than 25 degrees. Although the results of bracing are highly variable and dependent on compliance, brace quality, and length of time worn, bracing has been shown to decrease the progression of scoliosis. Typically, the brace is worn for 23 hours per day and only taken off for bathing or self-care purposes. The length of time a brace is worn depends on the compliance and progress observed during bracing treatment. Monitoring the child’s spine development with a painless routine x-ray is necessary to determine the efficacy of the brace.

In severe cases, which compromise pulmonary or cardiac function, or in progressive cases that have failed bracing and are associated with symptoms such as shortness of breath and back pain, surgery may be indicated. Deformity correction surgery usually involves a fusion of the affected vertebral bones within the spine and the use of support rods to provide mechanical stability while normalizing the spine alignment. This type of surgery can offer significant relief of symptoms and improve heart and lung function which are the organs most commonly compromised by severe scoliosis. Physical therapy to retrain the muscles and ligaments around the spine following this type of surgery is extremely important, and directly correlates to the overall success rate of the surgery.

Treatment at the Centers for Neurosurgery, Spine, and Orthopedics

At Centers for Neurosurgery, Spine, and Orthopedics, our neurosurgeons and orthopedic spine surgeons conservatively advise on whether surgery for scoliosis is necessary. The CNSO highly recognized experts, each with over ten years of successful experience, treating scoliosis, have been recognized as the best doctors for spine surgery in New Jersey, winning the “Top Doc” Award since 2013. CNSO offers comprehensive care from physical therapy for the spine to pain management experts who can offer nerve injections in order to reduce or eliminate pain. Physical therapy with compassionate spine experts is available at our Jersey City, Wayne, and Paramus locations. Contact CNSO today for more information.

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