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Scoliosis

Definition

Scoliosis is sideward bending of the spine and can cause side shift of the trunk, asymmetry of the hips and shoulders. Majority of patients do not have a known cause.

Diagnosis

Scoliosis is suspected on forward bending examination and confirmed with full length spine x-rays done while the child is standing. X-ray taken with the child facing away from the x-ray tube significantly decreases radiation exposure to the neck and breast tissue which is sensitive to radiation

Natural History

Scoliosis is likely to become worse during rapid growth in a child and from bone fragility in older age (after 45 years) and with bigger curves (more than 25 degrees).

Bracing

Scoliosis is not likely to decrease with any type of non operative treatment. Bracing may help in halting the progression of scoliosis in a growing child with curves between 25 and 40 degrees. Bracing is unnecessary for milder curves and not useful in mature children or larger curves (more than 45 degrees).

Surgery

Surgery is recommended to improve appearance and trunk balance or to decrease the risk of worsening of the curve to a severe degree. Curves more than 50 degrees are likely to worsen by 1-2 degrees every year even in a mature child and can reach to a severe magnitude at 40-50 years of age. Hence surgery is usually recommended in childhood when the curve is smalller, more flexible, and recovery is easier.

Patient Information

Download or view a pdf file on Scoliosis surgery - posterior spinal fusion - Information to the Patient.