A curve of at least 25 degrees is typically considered moderate scoliosis. The more a patient’s condition has progressed by the time they come to see me, the more work needs to be done to achieve a curvature reduction. Through our use of the latest digital X-ray technology, we can promise accuracy and minimal exposure to radiation. This includes physical therapy, as well as Caesar therapy and mensendieck. 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 Our approach involves ingenuity and dynamic thinking. The Scoliosis Reduction Center uses X-rays on a daily basis to diagnose, assess, and measure our patients’ scoliosis. Depending on the particular patient and the specific degree of curvature, this form of scoliosis may be treated successfully with non-surgical methods like bracing, physical therapy, and pain medications. When Idiopathic Scoliosis Needs Treatment. I would turn the clocks back to that initial diagnosis, in the doctor’s or specialist’s office, and I would start the treatment clock that very day. These experts treat diseases of the bones and muscles. Large lateral curve. When it comes to diagnosing and classifying a patient’s scoliosis, an X-ray is the gold standard. Fortunately, there are other well-established forms of treatment that are successful in slowing a curvature’s progression, achieving a reduction, and allowing patients to live their best lives while doing so. With an adult, however, it is very likely that pain will be a symptom. More significant cases may be treated nonsurgically, using braces, or with spine fusion surgery. I do believe that my patient-centered customized approach treats the whole patient by taking into account the many different levels of a person’s life that are impacted by the condition. This is true for both teen and adult patients. The main reason for the rapid rise in surgical interventions is possibly due to improper conservative care. Scoliosis is determined when the curvature of the spine measures 10 degrees or greater on an X-ray. 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. What degree of scoliosis requires surgery in adults Usually, when it comes to scoliosis in adults, surgery is only prescribed as a last resort option when the … In as little as two weeks, 98 percent of our patients show improvements in relief and function. In general, a curve is considered significant if it is greater than 25 to 30 degrees. 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. Mild cases may not require any treatment. My treatment approach diverges from the traditional approach by focusing on maintaining functionality and encouraging my patients to not let their condition stand in the way of their passions and goals. A spine that is held in place by rods and screws is also less flexible. Scoliosis is a condition characterized by a sideways curvature of the spine that coincides with spinal rotation. In the majority of AIS patients, little or no treatment is required. Here are a few treatment options for scoliosis. Surgical treatment is reserved for curves which are generally greater than 50 degrees for adolescent patients and adults. Curves may be as mild as 10 degrees, or as severe as 100 degrees or more. The goal of treatment for your child is to reach the end of their growth with a curve of less than 50 degrees. In most cases, it will take at least a 10-degree deviation from straight to be diagnosed as scoliosis. Realistically, there is no known cure for scoliosis, only ways to manage it and prevent its progression. Scoliosis treatment is based on the degree of curvature of the spine, viewed from the front or back by X-ray. Traditional treatment: even at a 10, 15, or 20 degree of curvature, typically, no active treatment is started. Physical examination for scoliosis mainly consists of the Adam's forward bend test (Figur… Its degree of severity is determined via X-ray and a measurement known as the Cobb angle; this measurement uses the apex of the curve to class the curvature as mild, moderate, or severe. It’s one thing for an adult patient to come to me seeking ways to manage the pain related to their scoliosis or seeking new treatment options; it’s quite another for parents and caregivers who are advocating for their loved ones and have the added pressure of trying to decide which treatment option is best for them. Less than 20 Degrees Slight curvatures of the spine (generally less than 20 degrees) are the most common form of scoliosis. Knowing the condition severity, age, curvature location, and cause of a patient’s condition helps determine the best possible course of treatment. My alternative treatment option is a chiropractic-centered functional approach. Copyright © 2020 - Scoliosis Reduction Center. 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. The goal is always to decrease pain and improve function. In many cases of severe scoliosis, spinal-fusion surgery is recommended as the best, and sometimes the only, treatment option. Spinal-fusion holds the spine in position, but being held in a corrective position is a lot different than actually achieving a reduction through natural means, such as chiropractic adjustments, and the spine maintaining that position naturally and functionally. The key to diagnosing scoliosis early is knowing what to look for. Also, during growth spurts, the time in-between X-rays can be too long. Unless you’re a scoliosis specialist or are constantly on the watch for symptoms, it’s hard to diagnose. If this curvature is not more than 25 degrees, your doctor may suggest exercise therapy. A visual test such as the Forward Bend Test, also known as the Adam’s Test, will likely be performed. 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. Obviously, I can’t say that there aren’t situations where spinal-fusion surgery is a favorable option, but I can say that it should be a last resort- after all other forms of treatment have been attempted. The degree of correction from surgery depends on how flexible your scoliosis is before your operation. It’s at this point that I highly recommend patients ensure they’re working with a scoliosis specialist. Most scoliosis does not require treatment. The traditional treatment approach would start when a curve reaches or progresses past 25 degrees. 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. 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. See Bracing Treatment for Idiopathic Scoliosis . Patients with congenital scoliosis must be evaluated for cardiac and renal abnormalities. 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. The advantages of the techniques : No transplant required. Of course, this is not exact as the condition develops across a wide spectrum with treatment decisions that work for one case not working for another, not to mention other important variables such as age. See Bracing Treatment for Idiopathic Scoliosis . Surgery can be performed for smaller curves if the appearance of the curvature is bothersome to the patient or if symptoms are associated with the scoliosis in the adult patient. Idiopathic scoliosis appears to be primarily a neuro-hormonal condition that is driven by genetic predisposition and metabolic factors. Understanding a condition from a number of important touch-points increases the likelihood of the patient’s condition being treated successfully. Regarding the question of what scoliosis degree requires surgery, that answer will differ greatly based on the treatment approach that has been chosen. 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. Numbness 3. Curvature under 10 degrees is considered a normal variation, just as there is a normal range for weight and height. While we can’t manage or control our patients’ growth, we can certainly monitor it and counteract the resulting progression. … 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. A scoliosis curve usually does not improve without 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. Scoliosis, the medical term for curvature of the spine, affects millions of people, an estimated 2 to 3 percent of the population. We work closely with our patients and their caregivers to decide which treatment options are best for them. Often, braces will be suggested as part of traditional treatment. Our team, under the leadership of Dr. Tony Nalda, is focused on treating your scoliosis in the most patient-centered, effective manner possible. A mild classification would include a spinal curvature measuring up to 25 degrees. Surgical treatment is reserved for curves which are generally greater than 50 degrees for adolescent patients and adults. Most children with scoliosis will have mild cases that only require monitoring every four to six months. Scoliosis surgery is becoming all too common in Asia. 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. 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. They see lots of teens with scoliosis and can decide if you need treatment. As older adults, these people may have a slightly higher incidence of back pain than the general population, as shown by Hong et al. Observation. Although it is estimated that over 4% of individuals have some degree of scoliosis, many people have never heard of (or know very little about) this condition. Standing X-rays taken of the spine from the back and side will measure the degree of a spinal curvature and place it on the spectrum of mild-to-severe scoliosis. Below is an up-to-date summary of facts about scoliosis. The kind and degree of the curve. Children with curvatures under 30 degrees usually do not require any treatment at all. May 24 2017. In this review, basic knowledge and recent innovation of surgical treatment for scoliosis will be described. Scoliosis ranges from 10-20 degrees (mild), 20-50 degrees (moderate), and severe (greater than 50 degrees). When the body is bent over, the spinal cord is more visible. Patients who come to me post-surgery are often seeking help managing their pain and looking to improve their mobility and flexibility. While there is no known cure for scoliosis, there are known treatment options. As adolescent idiopathic scoliosis (AIS) is the condition’s most common form, we’ll focus on this age group. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. Determining what degree of scoliosis requires treatment is a complex issue. In general, the more flexible your curve is, the better the correction from surgery. The treatment for pediatric scoliosis depends on several factors: The type of scoliosis. The danger of watching and waiting, especially in cases of adolescent scoliosis, is that a huge growth spurt can occur between X-rays, resulting in rapid curvature progression and further funneling patients towards surgery. As with children, most adults who have scoliosis – whether they had it as kids or not – don't require treatment. 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. Degrees of scoliosis ranging between 20 and 50 are considered moderate scoliosis, and can usually be treated with a back brace. The number of remaining growth years your child has until skeletal maturity. Once a spine has been fused, it is less able to absorb force, limiting certain activities that are safe post-surgery. First described by Dr. John R. Cobb in 1948, Cobb angle is a measurement of the degree to which a spine deviates from a straight alignment. All Rights Reserved. From there, we design a customized proactive treatment plan that works to reduce the curvature and stabilize the scoliosis. Through engagement with their treatment and building as positive an association with their condition as possible, our patients are able to regain feelings of control over their lives and their bodies. While no one can tell just how much a patient’s scoliosis will progress, visual assessments and X-rays can give us the information we need to make our predictions as accurate as possible. Muscle weakness 2. While growth is no longer a factor for adults, progression is still a concern. A severe curve is more than 50 degrees. Mild curves, like those found in 90% of scoliosis cases, typically don’t require treatment. As with children, most adults who have scoliosis – whether they had it as kids or not – don't require treatment. A moderate curve is between 25 degrees and 40 degrees. The ultimate goal is to achieve a reduction and slow or stop the condition’s progression, and I take a functional approach that encourages staying active and mentally healthy throughout treatment. These outcomes are why I dedicated my life to finding an effective alternative scoliosis treatment path. While most doctors would be able to spot an abnormal spinal curvature, when it comes to being able to fully interpret a scoliosis X-ray, seeing a specialist is highly beneficial. A patient’s Cobb angle is measured by first locating the most tilted vertebra at the apex of the curve. Through scoliosis-specific chiropractic care and exercises, custom 3-D bracing, and therapy, my team and I offer our patients the benefits of a variety of treatment approaches. The degree of correction from surgery depends on how flexible your scoliosis is before your operation. The number of remaining growth years your child has until skeletal maturity. At the Scoliosis SOS clinic in London, we practice an alternative form of scoliosis treatment called ScolioGold therapy. We want our patients to engage with their condition, not be ruled by it. 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. Spinal curvatures under 40 degrees, in pre-pubescent children, may be treated with a brace to slow the progression of scoliosis. When it comes to treating scoliosis, the goal is to manage and control its progression. 25- to 39-degree curve. In order for a patient to receive an official scoliosis diagnosis, a visual assessment will be done and an X-ray will be taken. Welcome to Scoliosis Reduction Center. Thoracic scoliosis: curvature in the spine’s middle portion (most common), Lumbar scoliosis: curvature in the spine’s lower portion, Thoracolumbar scoliosis: curvature that includes both lower thoracic and upper-lumbar vertebrae, Dextroscoliosis: sideways curvature that bends to the right, Levoscoliosis: sideways curvature that bends to the left, Congenital scoliosis: develops as a result of malformed bone the patient was born with, Neuromuscular scoliosis: develops as a secondary complication of diseases such as cerebral palsy or muscular dystrophy, Degenerative scoliosis: develops in older people whose spinal discs have degenerated with age, Traumatic scoliosis: develops as a result of an adverse trauma to the spine, Coreconcepts.com.sg - ‘Cobb Angle and Scoliosis’. Curvature under 10 degrees is considered a normal variation, just as there is a normal range for weight and height. If a curve has reached 20 degrees and the child or adolescent is still continuing to grow, bracing might be considered. Between observation for the mildest cases, and surgery for the most severe, there are many different therapeutic approaches geared towards helping manage scoliosis symptoms and progression. 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 In general, the more flexible your curve is, the better the correction from surgery. 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. No big cuts. In adults, the degree of the spinal curve may or may not determine treatment. See Scoliosis Treatment. 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. While most people are going to have some degree of spinal curvature, if the spinal curvature starts to impact someone’s health, then it is termed scoliosis and medical treatment is required. Whether or not surgery is recommended depends upon the condition’s severity, age of patient, treatment approach, and the surgical threshold of the country in which the surgery will take place. Scoliosis spinal fusion surgery may be reco… The 3 most common treatment options that our scoliosis specialists recommend are observation, bracing and surgery. 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… While the traditional approach might suggest that there’s no harm in watching and waiting, I firmly believe the opposite is true. The Cobb angle refers to the angle formed between those two parallel lines. A measurement of 20 to 40 degrees will generally result in the Orthopaedic doctor prescribing a back brace to prevent the curvature from worsening. We actually encourage our patients to keep doing the physical activities they love. Scoliosis is about two times more common in girls than boys. They include: Non-structural: In this type of scoliosis, the spine is curved abnormally; however, it still functions normally. The treatment for idiopathic scoliosis is based on age, curve magnitude and risk of progression, and includes observation, orthotic management and surgical correction with fusion. There are two broad categories of scoliosis. Age is particularly important to scoliosis because there is a marked difference between how adolescents and adults experience scoliosis-related pain. Adolescent scoliosis is the largest group of diagnosed scoliosis patients. Scoliosis is defined as spinal curvature greater than 10 degrees. A lot of the mystery that still surrounds scoliosis is because of how difficult it is to diagnose. Typically, a doctor will advise observation for a scoliosis curve that has not yet reached 25 degrees. Treatment is required for scoliosis that is progressive. Just as laws vary from state to state and country to country, healthcare-industry protocols and guidelines also vary. Abnormal reflexes The three-dimensional change in the spine's alignment the curve is a just a symptom of the conditi… Every 4 to 6 months, the doctor will take another X-ray of the spine to see if the scoliosis is progressing or not. Scoliosis, the medical term for curvature of the spine, affects millions of people, an estimated 2 to 3 percent of the population. 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. Keeping a close watch on a patient’s posture is also a large part of my monitoring strategy. If your child has only a slight curvature of the spine – less than 20 degrees – no immediate treatment is needed. This also involves restrictions placed on physical activity. 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. 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. When paired with a scoliometer, a Forward Bend Test is a reliable means of finding indicators of the condition and the need for a scoliosis X-ray. 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. A severe designation: a curvature that is measured at 40 degrees or more. The States has the lowest surgical threshold with surgeons most often recommending spinal-fusion surgery for severe cases with curvatures of 40-plus degrees or where progression is rapid. The traditional approach supports the practice of watching and waiting to see if a patient’s condition progresses in severity to the point where spinal-fusion surgery is deemed necessary. Treating 20 degree scoliosis Young patients with mild scoliosis will usually be recommended to wear a specially-fitted back brace - read about bracing here. What degree curve do you decide to do a brace? In general, the larger the curve’s Cobb angle, the more likely it will progress. In Canada, that threshold is higher at approximately 55 degrees and Europe is at the highest with approximately 60 degrees. Only a small percentage of scoliosis patients require treatment. Slight curvatures of the spine (generally less than 20 degrees) are the most common form of scoliosis. Treatment options for idiopathic scoliosis could include: Observation. Most cases of scoliosis are mild and don’t need treatment. A measurement of 20 to 40 degrees will generally result in the Orthopaedic doctor prescribing a back brace to prevent the curvature from worsening. Treatment for adolescent idiopathic scoliosis determined by the degree of the spinal curve at the time of diagnosis and by … Here at the Scoliosis Reduction Center, when patients come to me, I use several measurements to assess their condition. Based on the traditional approach, a surgeon in the States often suggests surgery when progression is rapid or a patient’s Cobb angle measurement is 40-plus degrees. Here at the Scoliosis Reduction Center, we don’t watch and wait: we act. She was diagnosed with scoliosis after her brother required spinal surgery for his own severe curvature. The USPSTF suggests that most patients who need treatment will be detected without screening,14 when presenting with visible curvature or possibly incidentally during another type of examination. Conditions are classified for a number of reasons. 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