When the Spine Curves: Treatments for Scoliosis

The Treatment of Scoliosis

Estimating Progression

Many scoliotic curves are mild and do not progress to a point where treatment is needed. However, once a curve develops beyond 30 degrees, especially if further progression is expected, treatment is recommended.

Factors involved in predicting an increase in the severity, or further progression, of a scoliotic curve:

• Curve pattern - Double curves are more likely to progress than single curves. The lumbar major curve is the least likely to progress.
• Age - The risk of progression decreases with age.
• Puberty - A curve detected before menstruation has a greater possibility of progression.
• Bone maturity - Maturity is measured on the Risser scale. The scale ranges from 0 to 5, with 0 being the least mature and 5 the most mature. A curve is more likely to progress if detected prior to skeletal maturity.
• Curve magnitude - The larger the curve at detection, the greater the risk of progress.
• Gender - Scoliotic curves are more likely to develop into large curves in women. Curves in men usually remain mild throughout life.

The Increase in Curvature in Adult Scoliosis
The curves resulting from scoliosis usually progress the most during adolescence. This is the time of greatest change in the body. However, a scoliotic curve may also progress one to two degrees each year in adulthood. As a result, biannual examinations are advisable if curve progression is a possibility. Adult patients with prolonged pain are also advised to seek a medical evaluation.

Factors that influence curve progression in adults:

• Degree of curvature - Adults with a small curve, fewer than 30 degrees, have little chance of progression. Those with curves from 45 to 50 degrees are at great risk.
• Age - Women experiencing menopause or adults with osteoporosis may have significant progression.

Pregnancy usually does not cause a mild or moderate scoliotic curve to progress. Scoliosis may increase back pain during pregnancy, but nothing more. Few women experience complications due to scoliosis.