My approach is a functional one, meaning the goal is to improve and facilitate the spine’s function, rather than holding it in a straighter alignment at the cost of mobility. How scoliosis is classified is important because it determines how a condition should be treated and how the patient is likely to experience their condition. Surgical treatment is reserved for curves which are generally greater than 50 degrees for adolescent patients and adults. Copyright © 2020 - Scoliosis Reduction Center. Most often, it is recommended that X-rays are taken every three-to-six months to watch and wait to see if the spinal curvature is progressing and at what rate. The kind and degree of the curve. As scoliosis is a 3-D condition, relying solely on 2-D measurements of a curvature will fall short when it comes to customizing an effective treatment plan. While no one can look at a patient’s scoliosis and know exactly how their condition is going to progress, age can help us predict how likely it is that a patient will experience progression and how rapid that progression is likely to be. Patients with congenital scoliosis must be evaluated for cardiac and renal abnormalities. Treatment is more effective the earlier scoliosis is detected. Then intersecting perpendicular lines are erected from the two parallel lines from the curve’s apex and bottom. Curves may be as mild as 10 degrees, or as severe as 100 degrees or more. Back braces are best suited for treating moderate scoliosis because they can not reverse spinal curvature, they only prevent the condition from worsening too severely by holding the spine firmly in place. The most common form is idiopathic scoliosis (in which the cause is unknown), and it most commonly occurs between the ages of 10 and 18. A spine that is held in place by rods and screws is also less flexible. No big cuts. Age is particularly important to scoliosis because there is a marked difference between how adolescents and adults experience scoliosis-related pain. If a curve has reached 20 degrees and the child or adolescent is still continuing to grow, bracing might be considered. Scoliosis Surgery Treatment . The goal is always to decrease pain and improve function. The traditional treatment approach is a passive one. Typically, a doctor will advise observation for a scoliosis curve that has not yet reached 25 degrees. Babies and toddlers may not need treatment as the curve might improve over time. Regarding the question of what scoliosis degree requires surgery, that answer will differ greatly based on the treatment approach that has been chosen. Spinal-fusion surgery can straighten a crooked spine, but it doesn’t cure the condition, nor does it guarantee the patient’s condition won’t continue progressing or that subsequent surgeries won’t be necessary. As adolescent idiopathic scoliosis (AIS) is the condition’s most common form, we’ll focus on this age group. I can’t tell you how many parents and caregivers I’ve seen in tears because they so strongly regret the fact that instead of acting immediately, they took the dominant medical advice to watch and wait. If your child has moderate or severe scoliosis, it may seem like it's too late to correct the scoliosis curve without drastic measures like surgery or bracing. We actually encourage our patients to keep doing the physical activities they love. Unfortunately it most often develops in children, particularly female adolescents between the ages of 10 and 15. If you or a loved one are facing the possibility of spinal-fusion surgery to treat scoliosis, I urge you to first explore other options such as my scoliosis-specific chiropractic approach. Taken from a variety of angles, I use X-rays to view what’s happening with the spine in terms of twist, tilt, and other important factors. Patients who come to me post-surgery are often seeking help managing their pain and looking to improve their mobility and flexibility. A patient’s Cobb angle is measured by first locating the most tilted vertebra at the apex of the curve. Realistically, there is no known cure for scoliosis, only ways to manage it and prevent its progression. This is because there are two main approaches to treating the condition and they differ widely. The advantages of the techniques : No transplant required. To return to the original question of what degree of scoliosis requires treatment, by now you know that the answer will change depending on the approach you’ve chosen. During this test, the patient is told to stand up straight, then bend forward, as if touching their toes, at a 90-degree angle. Brace treatment is generally used to prevent scoliosis from getting worse when you have: A curve that is moderate in size (20 to 40 degrees) AND; A curve that is progressive (has increased by more than 5 degrees) OR; A curve that is over 30 degrees when first diagnosed AND; A lot of growing yet to do Here at the Scoliosis Reduction Center, when patients come to me, I use several measurements to assess their condition. The recommendation for surgery is only a guideline and is often subjective, which is a major concern for patients making decisions about scoliosis treatment. Girls are much more likely than boys to require treatment. Mild cases may not require any treatment. Brace treatment is generally used to prevent scoliosis from getting worse when you have: A curve that is moderate in size (20 to 40 degrees) AND; A curve that is progressive (has increased by more than 5 degrees) OR; A curve that is over 30 degrees when first diagnosed AND; A lot of growing yet to do These cases are the hardest for me because I hear so often, “I wish I had known about you and your approach earlier.”. We want those patients to be able to live their best lives. The type of brace and amount of time it should be warn … The following are general guidelines for treatment. X-rays are noninvasive, accessible, reliable, inexpensive, and quick. The Scoliosis Research Society estimates that approximately 1 in 40, or 7 million people are affected by scoliosis in the United States alone, making it an extremely prevalent condition. Most patients recover from surgery with curves that have been straightened to less than 25°. Mild curves, like those found in 90% of scoliosis cases, typically don’t require treatment. Spinal curvature from scoliosis may occur on the right or left side of the spine, or on both sides in different sections. Observation. In the vast majority of cases, scoliosis doesn’t require treatment at all. Most cases of scoliosis are mild and don’t need treatment. A look at how our understanding of scoliosis treatment has developed over time. When it comes to spinal-fusion, after the age of 40, the question changes from “will there be complications” to “how bad will the complications be.”. From there, a parallel line is drawn to the superior vertebral end plate. There is no curing scoliosis, but there are different approaches to managing and controlling its progression. The number of remaining growth years your child has until skeletal maturity. In general, the more flexible your curve is, the better the correction from surgery. What the surgery does is treat the main symptom of the condition - the abnormal curvature - but it doesn’t treat the underlying condition itself; that’s what we do here at the Scoliosis Reduction Center. Image Source: Arallyn on Flickr . The rods act as a splint to hold the spine in position as the bones fuse; the initial fusion can take between 3 and 6 months, with full fusion taking up to 12 months after surgery. Severe migraines as a young teen introduced Dr. Nalda to chiropractic care. These variables are also beneficial in preparing the patient for what to expect in terms of the scoliosis-related symptoms they are most likely to experience. After experiencing life changing results, he set his sights on helping others who face debilitating illness through providing more natural approaches. What often happens in the traditional approach is that a patient is observed until their condition progresses to a certain severity level and surgery is then recommended as the best option, but that surgery can come at a high price, and not just in monetary terms. The challenge for the primary care physician is differentiating adolescents with higher-risk scoliosis requiring referral or intervention from those with lower-risk scoliosis requiring observation and no intervention. See Bracing Treatment for Idiopathic Scoliosis . For example, if two adolescents with scoliosis have the same amount of skeletal growth remaining but one has a 20-degree curve and the other already has a 30-degree curve, the person with the larger curve is likely to experience more curve progres… My issue with this course of treatment is that at 25 degrees, a patient is already 15 degrees from a surgical-level curve. Scoliosis is a condition characterized by a sideways curvature of the spine that coincides with spinal rotation. Spinal-fusion surgery is an invasive and lengthy surgery that, I believe, should only be considered as a last option when every other form of treatment has been unsuccessful. … Your child's age. A curvature of 10 degrees is regarded as a minimum angulation to define scoliosis. Our team, under the leadership of Dr. Tony Nalda, is focused on treating your scoliosis in the most patient-centered, effective manner possible. The 3 most common treatment options that our scoliosis specialists recommend are observation, bracing and surgery. Once a patient receives an official diagnosis and has a Cobb angle measurement via X-ray, other variables such as age, location of the curvature, and cause further classify the condition. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. Scoliosis Surgery. I’m not here to say I have the only effective scoliosis-treatment approach, but obviously, I do strongly believe that my approach is the best chance patients have of avoiding painful surgery and the risks and limitations that come with it. Due to the spine’s lengthening motion during the growth that characterizes the adolescent stage, many young people don’t experience pain as part of their condition. The treatment for pediatric scoliosis depends on several factors: The type of scoliosis. Curvature under 10 degrees is considered a normal variation, just as there is a normal range for weight and height. Curves less than 50 degrees at the end of growth do not usually require surgery or keep getting bigger. Living with a fused spine can have a heavy emotional weight. Based on my functional approach, I would say there’s very rarely a case where surgery is the best option. Mild curves, like those found in 90% of scoliosis cases, typically don’t require treatment. As growth and lengthening is no longer a factor, the curvature can cause compression of the spine, resulting in various levels of pain and discomfort. In most cases, it will take at least a 10-degree deviation from straight to be diagnosed as scoliosis. Doctors often recommend spinal fusion surgery for people with severe scoliosis (50 degrees or more), but surgery is generally not your best long-term option. Keeping a close watch on a patient’s posture is also a large part of my monitoring strategy. While there are several variations of the surgery, most use hardware such as hooks, bolts, and screws that are attached to the spine so long rods can be anchored on each side of the spine to hold it in a corrective position. Custom 3-D bracing has its place, but we make sure that it doesn’t come at the expense of the patient’s mindset or quality of life. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. Through our use of the latest digital X-ray technology, we can promise accuracy and minimal exposure to radiation. Out treatment plans prioritize strengthening the spine through natural means, rather than holding it with a brace or rod. In many cases, a scoliosis diagnosis is accidental. Treatment for scoliosis depends on your age, how severe the curve is, and whether it's likely to get worse with time. Scoliosis ranges from 10-20 degrees (mild), 20-50 degrees (moderate), and severe (greater than 50 degrees). Bone grafts are most often taken from a donor, the patient, or a bone bank (allograft). Our team, under the leadership of Dr. Tony Nalda, is focused on treating your scoliosis in the most patient-centered, effective manner possible. Scoliosis takes many forms. A measurement of 20 to 40 degrees will generally result in the Orthopaedic doctor prescribing a back brace to prevent the curvature from worsening. 10-24º Category: Case 2 Result Details. 25- to 39-degree curve. Surgical treatment for scoliosis is indicated, in general, for the curve exceeding 45 or 50 degrees by the Cobb's method on the ground that: 1) Curves larger than 50 degrees progress even after skeletal maturity. The most common form is idiopathic scoliosis (in which the cause is unknown), and it most commonly occurs between the ages of 10 and 18. Bracing. In this instance, the patient’s age is one of the main factors that determine how painful the condition is likely to be, and age is also an important factor when it comes to deciding whether surgery is an option or not. Unless you’re a scoliosis specialist or are constantly on the watch for symptoms, it’s hard to diagnose. Treatment for adolescent idiopathic scoliosis determined by the degree of the spinal curve at the time of diagnosis and by … Adults over the age of 50 are also more likely to experience the type of disc degeneration that can cause a spinal curvature to develop. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films. Patients with congenital scoliosis must be evaluated for cardiac and renal abnormalities. The traditional treatment path is frequently traveled, and it is the path most likely to involve passive observation and end with a recommendation for spinal-fusion surgery. Scoliosis of 3 and 4 degrees is treated promptly. Scoliosis is a complex condition with many fluctuating variables and symptoms differing from one patient to the next. Idiopathic scoliosis, which makes up over 80% of all cases, has no known cause but that doesn't mean we don't know much about the condition. Treatment is required for scoliosis that is progressive. In addition, the main goal is to stop further lateral curving of the vertebral column. As its ability to absorb shock is compromised, certain activities are no longer safe, and many people struggle with trying new things or just enjoying day-to-day life without worrying about what their spine can and can’t handle. The Cobb angle refers to the angle formed between those two parallel lines. The traditional approach relies heavily on the use of X-rays to monitor a curve’s progression, but I find there’s a shortcoming to relying so heavily on X-rays as it provides only a 2-D measurement of a 3-D condition. Conditions are classified for a number of reasons. Through hard work and ingenuity, the Scoliosis Reduction Center has helped transform the lives of thousands of people living their best lives with the condition. Scoliosis severity is a big component when it comes to deciding on a treatment plan, and scoliosis degrees of curvature classify a condition as mild, moderate, or severe. Final Curve Size: 7 degrees Scoliosis Reduced By: 68% Age at Start of Treatment: 12 years old Risser at Start of Treatment: Risser 1 Observation Period: 18 months . These outcomes are why I dedicated my life to finding an effective alternative scoliosis treatment path. The next range of 10 to 15 degrees does not normally require treatment other than monitoring by an Orthopaedic doctor until the patient has gone through puberty. Alternative Chiropractic-Centered Functional Approach. Scoliosis treatment is based on the degree of curvature of the spine, viewed from the front or back by X-ray. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment. If your child has this condition, your family doctor may recommend the wait-and-see approach. Mild scoliosis: Cobb angle measurement of 25 degrees or less, Moderate scoliosis: Cobb angle measurement between 25 and 40 degrees. 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