Help - my child has scoliosis

Treatment For Adolescent Idiopathic Scoliosis

If their child/teenager’s curvature is less than 25º, a public hospital will simply observe their scoliosis at 4 to 6 month intervals. Should their curvature then progress to >25º, bracing is prescribed, and if bracing is not successful, and their child’/teenager's curvature continues to progress to >40º, spinal fusion surgery is, as a matter of course, always prescribed.

Critical questions for parents

Thoracic Spine Correction

Critical questions then for parents to ask is: at what stage during the treatment cycle should bracing be prescribed for their child/teenager? Could bracing have been prescribed earlier rather months and months of observation? And, when bracing is prescribed, is the hospital prescribed brace the only bracing option? 

If the hospital's brace is the only option, what is the likelihood that it will prevent their child/teenager's curve from progressing to >40°, the arbitrary threshold at which spinal fusion surgery is prescribed? And, with regards to spinal fusion surgery, what are the risks and possible long term complications? Is living with and managing idiopathic scoliosis with conservative treatment a better option?

In all cases of Juvenile and Adolescent idiopathic scoliosis where there is a high risk of progression, timely conservative treatment intervention is key to prevent curvatures reaching the threshold where surgery will inevitably be prescribed. So finally, the question parents need to ask is what helpful 'alternative' treatment options are available, which if undertaken during and in addition to the hospital's observation treatment phase, could possibly help avoid spinal fusion surgery? 

Schroth Method Scoliosis Exercise Treatment

Adolescent Idiopathic Scoliosis is a three-dimensional (3D) disorder and therefore requires a 3D conservative treatment approach to counteract the scoliosis, elongate and stabilise the spine three-dimensionally. 

Schroth physiotherapeutic scoliosis-specific exercise treatment has been proven to: prevent progression; improve function; and reduce pain and disability in patients diagnosed with idiopathic scoliosis. Schroth exercises when performed in conjunction with bracing has improved bracing outcomes in patients with curvatures greater than 40º degrees, thus avoiding the need for spinal fusion surgery.

The following images are those of an adolescent female patient, who over a 2 year period, committed to a program of Schroth 3D exercises in conjunction with wearing a 3D Chêneau style asymmetrical brace. Her posture, as can be seen, improved dramatically.

Long Term Quality of Life?

In terms of quality of life, as previously stated, there is evidence which suggests conservative non-invasive treatment, such as Schroth 3D exercises and bracing, can prevent curvature progression in adolescent patients and avoid spinal fusion surgery.

A Critical Review written by the authors cited below concludes that: "there is no evidence that spinal fusion surgery improves quality of life for AIS [adolescent] patients versus natural history [of their scoliosis].”

Citation: Weiss HR, Moramarco M, Moramarco K. Risks and long-term complications of adolescent idiopathic scoliosis surgery versus non-surgical and natural history outcomes. Hard Tissue 2013 Apr 30;2(3):27.