Scoliosis

Treatment

Children with mild scoliosis (less than 20 degrees curvature) are examined every four to six months while they grow. If the curve doesn't increase, treatment usually isn't needed. If the curve worsens, Mayo Clinic specialists usually recommend bracing or surgery. The younger the child, and the more severe the curve, the more likely scoliosis is to worsen and need treatment.

Bracing

A brace is sometimes worn until the child stops growing.

Mayo Clinic specialists usually recommend a brace for children who are still growing and have a spinal curve of 25 to 40 degrees. Wearing a brace can't cure scoliosis. But it can prevent the curve from worsening, and avoid the need for surgery. The brace usually is worn until the child stops growing (about age 15 for girls, age 17 for boys). Children who wear braces can usually participate in most activities.

Mayo Clinic orthopedists and nurse practitioners work closely with orthotic specialists to ensure the brace is fitted and adjusted correctly. It's important to wear the brace exactly as prescribed, to get the full benefits of treatment. Mayo researchers have found that a brace is nearly 100 percent effective in preventing surgery if the brace is correctly fitted and the child wears it as directed.

Casts

Mayo Clinic specialists may recommend a body cast for children ages 1 to 3 whose spinal curve is too severe for bracing. The body cast allows the child to move normally, and can avoid or postpone the need for surgery. The cast is usually changed every six months.

Surgery

Before treatment. See enlarge for after.

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Spinal fusion is usually needed to correct spinal curves greater than 40 to 50 degrees. Surgery may also be needed for milder curves in certain areas of the spine and for adults with scoliosis who have pain.

Scoliosis surgery is usually done through an incision in the back. The surgeon attaches metal rods and hooks or screws to the spine to correct the curve. As healing occurs, some of the spinal bones fuse (grow together) and hold the correction in place. Additional surgery may be needed through the front or side of the body to correct very rigid or severe curves.

X-rays before treatment. See enlarge for after.

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Scoliosis surgery is one of the longest and most complicated orthopedic surgeries performed on children. The child is usually hospitalized for six days, and activities are restricted for several months. Surgery can affect the child's growth. If possible, Mayo Clinic surgeons try to delay surgery until most of a child's growth is complete. The average age for scoliosis surgery is 13 years.

Growing Rods and VEPTR

Growing rods are a surgical option for young children (typically under age 10) who are still growing. The rods are surgically attached to the child's spine, and can straighten a curve that is too severe for bracing. But unlike traditional scoliosis surgery, the metal implants don't affect the child's growth. The rods are surgically adjusted as the child's spine grows, usually every six months.

An adjustable growing rod

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Vertical expandable prosthetic titanium rib (VEPTR) is similar to a growing rod, but the metal implants are attached to the ribs. Mayo Clinic specialists may recommend VEPTR for children whose scoliosis causes breathing problems.

Compassionate support

Mayo Clinic doctors and nurse practitioners work closely with families to help them cope with the physical and emotional challenges of scoliosis treatment. Mayo professionals can recommend ways to forge strong support from friends and family to help ensure successful scoliosis treatment.