Scoliosis is a condition where the spine (backbone) develops an irregular sideways curvature, often resembling a “C” or “S” shape. This lateral bend contrasts sharply with the natural front-to-back curves—vital for healthy posture and movement.
Treatment options for scoliosis focus on correcting and managing the spinal curvature, with non-surgical choices such as bracing and physical therapy and surgical interventions like spinal fusion. The treatment is determined by factors such as:
- Patient’s age
- Curve severity
- Growth status
- Patient’s overall health
Understanding your unique path empowers confident discussions with a spine specialist and informed choices about your journey to well-being.
This guide clarifies the treatment options available for scoliosis at Spine 360. Let’s start with decoding the factors that impact these treatment choices.
Important Factors That Influence Your Scoliosis Treatment Choices
There isn't a one-size-fits-all approach when it comes to scoliosis. Scoliosis treatment choices are based on more than spine curvature alone; numerous personal factors could be taken into account in order to have an effective, customised approach.
Key factors are:
- Patient's age
- Skeletal maturity
- Remaining growth potential
How do doctors decide on the best treatment for scoliosis? Effective early detection and diagnosis, using physical examinations, imaging (like X-rays and CT scans), and reviewing medical and family history, allow your doctor to consider:
- The specific type of scoliosis—Idiopathic, Congenital, Neuromuscular, or Degenerative
- Curve severity (often measured by the Cobb angle)
- The risk of curve progression
- Any symptoms experienced, such as back pain
- Your personal lifestyle goals and activity expectations
Grasping these key elements is where you begin to get to know your course of therapy. In the following section, we shall look at the non-surgical treatment options for scoliosis.
Also Read: Essential Insights into Scoliosis Disease
Non-Surgical Treatment Options for Scoliosis
There are various non-surgical routes to treat spinal curvature using well-planned observation and active management strategies. Essentially, management of early-stage scoliosis typically starts with conservative measures aimed at monitoring progression and preserving the quality of life.
If the curve is less than 25 degrees (indicating mild scoliosis) and skeletal growth has reached a stable point (skeletal maturity), particularly when progression is gradual, the primary approach is tracking curve development through periodic X-rays or imaging. Orthopaedic teams use these results to assess progression patterns with minimal intervention.
For adolescent idiopathic scoliosis with moderate to severe curvature (25–45 degrees), scoliosis bracing (a customised brace worn around the torso) becomes crucial. Studies reveal that rigid braces worn have stopped curve progression in up to 75% of cases.
In such scenarios, doctors may advise adolescent patients to continue wearing spinal braces until they reach skeletal maturity and growth has ceased. This continuum of care strengthens the supportive muscles in the patient’s back and torso after prolonged inactivity.
At this stage, physical therapy may also be recommended as a valuable scoliosis care option. Doing exercises aimed explicitly at scoliosis will help:
- Strengthen the spine
- Minimise pain
- Maintain an ideal body weight
- Reduce the strain on the back
Of these non-surgical methods, the “Schroth Method” is notable for its distinctive approach. It uses specific geometric breathing patterns and positional holds, which help address musculoskeletal imbalances as patients learn to “derotate” their spine with the help of controlled movements under the supervision of a physiotherapist.
The scenario changes with adult scoliosis, where controlling symptoms (symptom management) is more important. Here, treatment is aimed at improving comfort by multiple means, rather than altering the current spinal curve.
The scoliosis management options include:
- Targeted joint mobilisations, such as osteopathic adjustments or chiropractic care
- Various mind-body practices, such as scoliosis-specific yoga sequences/engaging in Pilates to improve lateral flexibility and core stability and meditation/Cognitive Behavioural Therapy (CBT) to help manage associated anxiety
- Smart ergonomic modifications for office and sleep setups, alongside general lifestyle adjustments
Being aware of all non-interventional treatments gives you the knowledge to collaborate more effectively with your spine specialist when developing your personalised care plan. It is also worth considering that although spinal bracing may provide short-term pain reduction for some adults, it does not correct established curves in skeletally mature individuals.
However, if the curvature worsens despite non-surgical treatments, starts impacting organ function, or causes significant pain, you may want to consider surgical options—which we’ll explore next.
Surgical Treatment Options for Scoliosis
Surgeries become necessary/critical when the measurement of the curvature is more than 40–50 degrees (severe curves)/if you have debilitating pain, pressure on nerves (nerve compression), or a serious effect on your respiratory function and your overall well-being.
So, how is scoliosis treated surgically? Let’s unpack the approaches.
1. Spinal Fusion
Spinal fusion emerges as the most common and effective approach. In this procedure, implants are fixed to the patient’s spine to maintain its newly adjusted position until the vertebrae fuse together. Doctors may use the following spinal instrumentation:
- Titanium rods
- Screws
- Hooks
- Bands
- Wires
There are two ways to perform this procedure:
- Posterior Approach: This standard procedure entails instrumentation and bone grafting. Throughout the surgery, wires, hooks, or other implant anchors are placed at every vertebral level affected by the curvature. The surgeon approaches the spine from the back (posterior) when the patient is lying prone.
- Anterior Approach: In this approach, the surgeon accesses the spinal column through incisions made on the chest or abdomen to expose the anterior portion of the spine. The soft disc material between the bones is removed and replaced with a bone graft for extra stability.
This procedure provides critical patient results, mainly:
- Substantial curve correction, usually 60-100% in flexible spines
- The halting of further curve progression once fusion is solid
2. Minimally Invasive Surgery (MIS)
Minimally invasive spine surgery involves smaller cuts and offers a less invasive approach to treatment. Compared to traditional surgery, it often leads to:
- Less blood loss
- Smaller scars
- Shorter hospital stay
- Faster recovery
For a complete guide on this procedure, check out our blog: "What is Minimally Invasive Spine surgery?". However, it is not suitable for all cases and is typically used for specific types of scoliosis.
There are also different treatments for scoliosis for younger, growing children, including:
- Vertebral Body Tethering (VBT)
- Placing expandable rods that can be lengthened periodically to accommodate growth
Although scoliosis surgery is a safe process, the following surgical complications are possible:
- Infection
- Bleeding
- Implant problems (e.g., loosening/breakage)
- Spinal cord injury/nerve damage (rare)
- Post-operative stiffness (inflexibility) in the fused spinal segments
For complex adult scoliosis surgeries, complication rates can be as high as 30-40% and may sometimes require further procedures.
However, the choice to have surgery is very much personalised, and it is decided upon in consultation with your orthopaedic spine surgeon/neurosurgeon.
Also Read: Spinal Fusion Surgery- A Key to Enhanced Spine Health
Building Your Personalised Scoliosis Care Plan With Spine 360
Every scoliosis journey is unique, and not all curves require active treatment. In some cases, scoliosis care options like regular monitoring and non-surgical management may be sufficient.
However, early scoliosis diagnosis is vital, as timely interventions can prevent progression and potentially avoid surgery. Treatment options, varying from exercises and specific physical therapy for scoliosis to surgery, depend on the curve severity, always aiming to maintain your quality of life.
In the matter of scoliosis management, co-decision-making with your expert/specialist is key. This joint planning brings treatment choices in harmony with your daily life and future health (long-term).
At Spine 360, Bengaluru, we offer you an invaluable perspective. Our experts craft a customised treatment plan with your best interests and hopes for healthy, active living first.
Connect with us today and take the right steps towards improved spinal health!
