The treatment for scoliosis depends on the age of the patient, the severity of the spine condition, and the cause.

Most patients with idiopathic scoliosis who have a curvature that is less than 25 degrees, don’t need treatment. These patients will simply need to be observed at regular intervals of 4-6 months. Observation involves a physical examination and an X-ray.

“Children whose self-esteem is affected because of scoliosis, may need counselling support in addition to the normal treatment procedures,” says Dr Guo Chang Ming, Senior Consultant, Department of Orthopaedic Surgery, Singapore General Hospital (SGH), a member of the SingHealth group.

For significant cases of scoliosis, treatment options include:

• Braces: These body braces are prescribed for children whose bones are still growing. The child will have to wear the brace continuously for one or two years to halt the progression of the spinal curve. The brace will not reduce the curvature that is already present. In adult patients, braces are recommended for short periods, such as when they are doing manual work. Long-term use for adults can cause the spine to stiffen and the back muscles to weaken.
• Surgery: Surgery may be required if the scoliosis continues to progress despite the braces. Patients who have a spine curvature of 40-50 degrees may be recommended spinal fusion surgery. This involves a bone graft to permanently fuse the vertebrae. Metal rods, hooks and screws are used to hold the bones in place until they fuse.

One drawback of this fusion process for children is that the bones that are joined together stop growing – hence this surgical procedure is used as a last resort for children and adolescents who still have some growth years left.

“Back braces will not help patients with congenital scoliosis or those with neuromuscular scoliosis. Congenital scoliosis is also difficult to treat with surgery and may require multiple operations,” says Dr Guo.

In severe cases, the rib cage may press against the lungs and heart causing complications such as:

• Breathing problems
• Lung and heart damage
• Nerve damage
• Persistent back pain

Scoliosis cannot be overcome by correcting posture. Food, vitamin supplements and exercise programmes have also not been found to be helpful in treating the condition or halting its progression. However, scoliosis patients are advised to stay fit and active for a better prognosis.

“If patients get appropriate treatment for scoliosis at an early stage, they can go on to lead normal lives,” says Dr Guo.

Ref: S13