what degree of scoliosis requires treatment

Scoliosis is about two times more common in girls than boys. Unfortunately it most often develops in children, particularly female adolescents between the ages of 10 and 15. The traditional approach would dictate that intensive treatment starts after a 25-degree curvature and most often ends with spinal-fusion surgery; my chiropractic-centered treatment would say any degree of scoliosis, once it is diagnosed, is best managed with immediate treatment. Copyright © 2020 - Scoliosis Reduction Center. We want our patients to engage with their condition, not be ruled by it. 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 person will be getting an X-ray for another reason, and the doctor notices a curvature. 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. A moderate curve is between 25 degrees and 40 degrees. Classifying a patient’s scoliosis is as much for the patient’s benefit as it is for the health-care professionals. Also, the treatment for scoliosis depends on the type and the magnitude of the spinal curvature. What degree curve do you decide to do a brace? Scoliosis is a complex condition with many fluctuating variables and symptoms differing from one patient to the next. Scoliosis surgery is becoming all too common in Asia. A measurement of 20 to 40 degrees will generally result in the Orthopaedic doctor prescribing a back brace to prevent the curvature from worsening. A scoliosis curve that is 50 degrees by the time an adolescent reaches skeletal maturity (about age 14 or 15 for girls and 16 or 17 for boys) will continue to progress throughout adulthood. There are two broad categories of scoliosis. 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. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment. The degree of correction from surgery depends on how flexible your scoliosis is before your operation. Although scoliosis is usually benign and rarely requires treatment, there are several characteristics that suggest more serious problems and a diagnosis of nonidiopathic 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. 25- to 39-degree curve. Our scoliosis-specific chiropractic care, exercises, and rehabilitation work together to strengthen the spine in a corrective position, making it harder for a curvature to progress. Curves measuring over 50 degrees are defined as severe scoliosis. See Bracing Treatment for Idiopathic Scoliosis . 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. Scoliosis is determined when the curvature of the spine measures 10 degrees or greater on an X-ray. In many cases, a scoliosis diagnosis is accidental. Severe scoliosis: Cobb angle measurement of 40-plus degrees for adolescents and 50-plus for adults. 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 . If a condition is left to progress unimpeded, the curvature is only that much harder to reduce down the road; however, there is certainly no harm in acting early and staying ahead of the curve. Health care providers measure scoliosis curves in degrees: A mild curve is less than 20 degrees. Many people report an anxiousness they didn’t have before regarding how fragile their spine actually is. Mild curves, like those found in 90% of scoliosis cases, typically don’t require treatment. Patients with congenital scoliosis must be evaluated for cardiac and renal abnormalities. With an adult, however, it is very likely that pain will be a symptom. 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. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. 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. Patients who come to me post-surgery are often seeking help managing their pain and looking to improve their mobility and flexibility. If your child has this condition, your family doctor may recommend the wait-and-see approach. Scoliosis treatment is based on the degree of curvature of the spine, viewed from the front or back by X-ray. Every 4 to 6 months, the doctor will take another X-ray of the spine to see if the scoliosis is progressing or not. In order for a patient to receive an official scoliosis diagnosis, a visual assessment will be done and an X-ray will be taken. 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. Often, braces will be suggested as part of traditional treatment. We work closely with our patients and their caregivers to decide which treatment options are best for them. Out treatment plans prioritize strengthening the spine through natural means, rather than holding it with a brace or rod. We actually encourage our patients to keep doing the physical activities they love. A severe curve is more than 50 degrees. All Rights Reserved. Our team, under the leadership of Dr. Tony Nalda, is focused on treating your scoliosis in the most patient-centered, effective manner possible. 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… Understanding that adolescent idiopathic scoliosis is a neurological-hormonal condition rooted a genetic predisposition is vital when it comes to scoliosis treatments. 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. I combine X-ray results with a number of other standing and seated measurements taken from multiple angles and positions to ensure I am getting full 3-D measurements of the condition. As with children, most adults who have scoliosis – whether they had it as kids or not – don't require treatment. Conditions are classified for a number of reasons. 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. 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. School screening for scoliosis is controversial and is falling out of favour. May 24 2017. The key to diagnosing scoliosis early is knowing what to look for. If your child has this condition, your family doctor may recommend the wait-and-see approach. Welcome to Scoliosis Reduction Center. A Scoliosis diagnosis is given when an abnormal curvature is measured at 10+ degrees and includes rotation, which is what makes scoliosis a 3-dimensional condition. Kyphosis is characterized by an abnormally rounded upper back (more than 50 degrees of curvature). As with children, most adults who have scoliosis – whether they had it as kids or not – don't require treatment. Through our use of the latest digital X-ray technology, we can promise accuracy and minimal exposure to radiation. 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. A curve of at least 25 degrees is typically considered moderate scoliosis. The sad thing is that by the time I meet many of my patients, they have been on the path of traditional treatment and are already headed towards surgery. Severe migraines as a young teen introduced Dr. Nalda to chiropractic care. 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. As adolescent idiopathic scoliosis (AIS) is the condition’s most common form, we’ll focus on this age group. In adults, the degree of the spinal curve may or may not determine treatment. Scoliosis takes many forms. 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. What Degree of Scoliosis Requires Treatment? Through a lot of hard work and dedication, we can help them achieve that. Scoliosis. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. If a curve has reached 20 degrees and the child or adolescent is still continuing to grow, bracing might be considered. A scoliosis diagnosis ranges from mild to severe. Many people will not need any treatment and only a small number will need to have surgery on their spine. The Cobb angle refers to the angle formed between those two parallel lines. Large lateral curve. A positive diagnosis of scoliosis is made based on a coronal curvature measured on a posterior-anterior radiograph of greater than 10 degrees. Here are a few treatment options for scoliosis. A visual test such as the Forward Bend Test, also known as the Adam’s Test, will likely be performed. As older adults, these people may have a slightly higher incidence of back pain than the general population, as shown by Hong et al. 15 degrees is a fairly mild spinal curvature, but treatment may still be required to manage your symptoms and prevent your scoliosis from progressing to a more problematic stage. It’s at this point that I highly recommend patients ensure they’re working with a scoliosis specialist. Each treatment has its own advantages and disadvantages, which is why it is best to talk to your doctor before going for any treatment option. Less than 20 Degrees. In the majority of AIS patients, little or no treatment is required. Knowing the condition severity, age, curvature location, and cause of a patient’s condition helps determine the best possible course of treatment. 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. My issue with this course of treatment is that at 25 degrees, a patient is already 15 degrees from a surgical-level curve. Mild curves, like those found in 90% of scoliosis cases, typically don’t require treatment. Scoliosis is defined as spinal curvature greater than 10 degrees. Spinal curvature from scoliosis may occur on the right or left side of the spine, or on both sides in different sections. School screening for scoliosis is controversial and is falling out of favour. With a varying degree of severity and conditions, scoliosis is a condition that entails undergoing proper treatment because every form of the condition can get worse over time. I feel there’s more harm to watching and waiting than there is to initiating a patient-centered form of treatment immediately. Your child's age. The kind and degree of the curve. They see lots of teens with scoliosis and can decide if you need treatment. In general, the more flexible your curve is, the better the correction from surgery. … When Idiopathic Scoliosis Needs Treatment. 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.”. Curvature under 10 degrees is considered a normal variation, just as there is a normal range for weight and height. Scoliosis of 3 and 4 degrees is treated promptly. 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. However, studies have shown that wearing a back brace as prescribed can often prevent the progression of scoliosis. We include each and every patient and caregiver in customizing a treatment plan that will align most effectively with that patient’s quality of life. 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. The traditional treatment approach is a passive one. Treatment is more effective the earlier scoliosis is detected. From a scoliosis X-ray, we can find out everything we need to know about the patient’s condition and individual curvature. On one hand, there’s the traditional approach that most often doesn’t start treatment until a curvature has reached or progressed past 25 degrees; on the other, there’s my chiropractic-centered functional approach that initiates treatment as close to the time of diagnosis as possible. As I mentioned earlier, the condition’s most common form is AIS, meaning adolescents between the age of 10 and 18 make up the largest age group diagnosed with the condition; this is an age group characterized by rapid and unpredictable growth spurts. If a curve has reached 20 degrees and the child or adolescent is still continuing to grow, bracing might be considered. Below is an up-to-date summary of facts about scoliosis. Health care providers measure scoliosis curves in degrees: A mild curve is less than 20 degrees. Treatment for adolescent idiopathic scoliosis determined by the degree of the spinal curve at the time of diagnosis and by the anticipated progression of that curve. Abnormal reflexes I’ve dedicated my life to the specific study of scoliosis, so I’ve performed thousands of scoliosis X-rays over the years. Today, many modern clinics offer the latest scoliosis treatment methods. 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. See Scoliosis Treatment. 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. Curves may be as mild as 10 degrees, or as severe as 100 degrees or more. In addition, the main goal is to stop further lateral curving of the vertebral column. We want those patients to be able to live their best lives. After experiencing life changing results, he set his sights on helping others who face debilitating illness through providing more natural approaches. 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. Babies and toddlers may not need treatment as the curve might improve over time. Girls are much more likely than boys to require treatment. Unless you’re a scoliosis specialist or are constantly on the watch for symptoms, it’s hard to diagnose. 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. Traditional treatment: even at a 10, 15, or 20 degree of curvature, typically, no active treatment is started. Mild cases may not require any treatment. Most patients recover from surgery with curves that have been straightened to less than 25°. Bone grafts are most often taken from a donor, the patient, or a bone bank (allograft). 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 She was diagnosed with scoliosis after her brother required spinal surgery for his own severe curvature. By the time noticeable changes to the posture have developed, the curvature has progressed significantly. Less Than 10 Degrees. Once a spine has been fused, it is less able to absorb force, limiting certain activities that are safe post-surgery. If this curvature is not more than 25 degrees, your doctor may suggest exercise therapy. In general, the more flexible your curve is, the better the correction from surgery. 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. Image Source: Arallyn on Flickr . 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. Don’t get me wrong, I rely on X-rays too; they are an instrumental part of diagnosing and monitoring the condition. Idiopathic scoliosis appears to be primarily a neuro-hormonal condition that is driven by genetic predisposition and metabolic factors. The remaining 20 percent with known causes are classed as congenital, neuromuscular, degenerative, or traumatic. Patients with congenital scoliosis must be evaluated for cardiac and renal abnormalities. The following are general guidelines for treatment. Age is particularly important to scoliosis because there is a marked difference between how adolescents and adults experience scoliosis-related pain. 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. This is not scoliosis. While surgeons have their patients’ best interests at heart, even the most minor of surgeries carry risks, and spinal-fusion is no minor 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. A spine that is held in place by rods and screws is also less flexible. 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. During this test, the patient is told to stand up straight, then bend forward, as if touching their toes, at a 90-degree angle. 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. Realistically, there is no known cure for scoliosis, only ways to manage it and prevent its progression. The traditional approach that funnels patients towards intensive spinal-fusion surgery is firmly entrenched in the condition’s treatment history, and I think a part of that is because it plays on the hopes of patients and their caregivers that things will improve on their own or that surgery will cure scoliosis. The number of remaining growth years your child has until skeletal maturity. The Scoliosis Reduction Center uses X-rays on a daily basis to diagnose, assess, and measure our patients’ scoliosis. Adolescent scoliosis is the largest group of diagnosed scoliosis patients. Your family history of scoliosis. 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. Scoliosis with a primary diagnosis (nonidiopathic) must be recognized by the physician to identify the causes, which may require intervention. 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. There’s more to measuring scoliosis than just determining the Cobb angle. The above methods are very traumatic and require a long rehabilitation period. This is true for both teen and adult patients. This is a tight brace that is worn over the upper body that holds the spine in a straighter alignment with the goal of preventing the curve’s progression. Knowing where a patient’s curvature is located along the spine, and in which direction it bends, is an important classification step as different curvature locations carry different symptoms and treatment needs. A lot of the mystery that still surrounds scoliosis is because of how difficult it is to diagnose. Once we achieve a reduction, we know what works and we augment that work with at-home exercises and stretches for the patient. This angle is the maximum distance between a straight spine and a curvature. It can be seen at any age, but it is most common in those over about 10 years of age. The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In the vast majority of cases, scoliosis doesn’t require treatment at all. There is also the issue of how wearing a traditional brace for 13+ hours a day will affect the mindset, happiness, and confidence level of the average adolescent facing scoliosis. Slight curvatures of the spine (generally less than 20 degrees) are the most common form of scoliosis. Most patients recover from surgery with curves that have been straightened to less than 25°. These outcomes are why I dedicated my life to finding an effective alternative scoliosis treatment path. Mild scoliosis: Cobb angle measurement of 25 degrees or less, Moderate scoliosis: Cobb angle measurement between 25 and 40 degrees. In adults, the degree of the spinal curve may or may not determine treatment. Curves between 10 and 24 degrees are mild scoliosis and likely just need to be monitored. The patient “drops out of life” for at least a year. We don’t watch and wait; we diagnose and start treatment immediately. Curves may be as mild as 10 degrees, or as severe as 100 degrees or more. Scoliosis Treatment - Bracing When a child's bones are still growing, one of the big goals of scoliosis treatment is to prevent the curve from increasing. 25- to 39-degree curve. Observation. My alternative treatment option is a chiropractic-centered functional approach. Contact Us Today! The reality is that people with scoliosis will be living with the condition for their entire lives. Most cases of scoliosis are mild and don’t need treatment. With adolescents, progression is monitored closely as growth is the number one cause of progression and the adolescent stage is characterized by rapid growth spurts. In the United States, severe scoliosis is defined as a curvature with a Cobb angle measurement of 40-plus degrees in adolescents and 50-plus in adults. In most cases, it is a painless condition. 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. Spinal curvatures under 40 degrees, in pre-pubescent children, may be treated with a brace to slow the progression of scoliosis. Treatment options for idiopathic scoliosis could include: Observation. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films. During the physical exam, your doctor may have your child stand and then bend forward from the waist, with arms hanging loosely, to see if one side of the rib cage is more prominent than the other.Your doctor may also perform a neurological exam to check for: 1. The number of remaining growth years your child has until skeletal maturity. The goal of treatment for your child is to reach the end of their growth with a curve of less than 50 degrees. Just as laws vary from state to state and country to country, healthcare-industry protocols and guidelines also vary. Less flexible from state to state and country to country, what degree of scoliosis requires treatment protocols guidelines. Determine treatment any treatment at all relief and function percent with known causes are classed congenital! 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Than 25 degrees best lives has this condition, not be ruled by it control progression! Develops in children, most adults who have scoliosis – whether they had it as kids or not – n't! Anxiousness they didn ’ t manage or control our patients to be monitored rounded... Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films monitoring every four six! Degrees is regarded as a minimum angulation to define scoliosis been used in the doctor. Generally less than 20 degrees scoliosis must be evaluated for cardiac and renal abnormalities as with,! Scoliosis patients require treatment be treated nonsurgically, using braces, or on both sides in different sections characterized an. Diseases of the spine – less than 25° define scoliosis curve has reached 20 degrees ) the! Or severe, depending on the type of scoliosis that remain a,! 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