Boston Othotics and Prosthetics
Boston Othotic and Prosthetics

Scoliosis

What is scoliosis?

Scoliosis is a musculoskeletal disorder in which there is a sideways (lateral) curvature of the spine.

Are there different kinds of scoliosis?

Yes. Adolescent idiopathic scoliosis, which is usually diagnosed after the age of 10, is by far the most common type. Other types include infantile idiopathic scoliosis, which occurs in children younger than 3; juvenile idiopathic scoliosis, which occurs in children between the ages of 3 and 10; and neuromuscular scoliosis, which can occur at any age but is a result of another muscular condition, such as cerebral palsy. Learn more.

What causes scoliosis?

In adolescent idiopathic scoliosis, “idiopathic” means the cause of the condition is not clearly understood. There does seem to be a genetic component in some instances, but this is not always the case.

Who gets scoliosis?

There are many forms of scoliosis. The most common type (accounting for 80-85% of cases) is adolescent idiopathic scoliosis, which occurs after the age of 10, and predominantly affects girls. People of all ages can have scoliosis, but the focus of treatment is on children and adolescents. Of every 1,000 children, 3 to 5 develop spinal curves that are considered large enough to need treatment.

What is the treatment process for scoliosis?

Scoliosis is often noticed by a parent, family member or through a school screening process. From there, referral to an orthopedic spine specialist should take place. The doctor will suggest the best treatment for each patient based on the patient's age, how much more he or she is likely to grow, the degree and pattern of the curve, and the type of scoliosis. A simple X-ray can provide much of this information. From the X-ray, angles can be calculated to determine the exact degree of the curve(s). This is called the Cobb angle. The doctor may recommend observation, bracing, or surgery. Learn more.

Will my child need surgery for scoliosis?

Most of the time, no; surgery will not be needed. Our goal with bracing is to stop the curvature from progressing and reduce the need for surgical intervention. This is a collaborative effort with an appropriate brace prescribed by your MD and designed by your orthotist, good adherence to prescribed wear time, and regular follow-ups. In a recent long-term follow-up survey of patients treated with the Boston Brace, 83% of patients who adhered to prescribed wear time have not undergone surgery to date.

How important is physical therapy (PT) in scoliosis treatment?

There are different schools of thought on PT, especially when it comes to scoliosis management. Scoliosis Specific Exercises can teach patients how to improve their posture and move with the brace instead of against it, which can potentially enhance the effectiveness of the bracing treatment, although research is still limited on this subject. It all comes down to what is right for the individual, and what is right for one person may not be the best choice for another.

In fact, there are seven major schools of thought when it comes to PT management of scoliosis. PT intervention can range from periodic check-in visits with a home exercise program to programs with greater time commitment, such as Schroth. Just like every patient’s brace is a bit different and tailored to their curve and presentation, their physical therapy program also has to be unique to the patient in order to achieve the best outcomes. Bracing and PT are very complementary when it comes to the treatment of scoliosis, and each can benefit the other. PT can help reinforce the corrective posture obtained by the brace (and vice versa), and PT can also help develop and reinforce corrective movement patterns. Combined, they can lead to better outcomes for our patients.

Is scoliosis a deformity?

Scoliosis is a condition that involves an irregularity in the shape of the spine, but it is important not to refer to people with scoliosis as “deformed,” or having a “deformity.” Using this word is outdated, insensitive, stigmatizing, and emotionally harmful to scoliosis patients who are trying to understand and come to terms with their scoliosis diagnosis, and who want to be seen as a whole person rather than one aspect of their physical health.