Traditional Treatments for Scoliosis

Watching & Waiting

Costs*: USD$1,000+ per year (includes periodic X-Rays and doctor visits)

If you or your child is still young and your scoliosis curve is less than 20º, your doctor may recommend waiting and watching how the curve progresses. If you have completed your growth, and the curve is less than 50º then your doctor is also likely to recommend the observation method. This period consists only of regular visits to an orthopedic surgeon, along with full-spine X-Rays to gauge the progression of the spinal curve.

It’s not surprising to know that there have been no reported cases of scoliosis being improved by observation alone. We recommend proactively fighting the disease through specialised chiropractic treatment before the muscles and tissues of the body have been deformed.

Parents and the medical community have also highlighted valid concerns regarding the repeated “full spine X-rays” used to monitor the disease at this stage. One full spine X-ray exposes the patient to the same amount of radiation as seven of the precision X-rays we do to evaluate the degree of your scoliosis. Furthermore, the full-spine X-ray only tells the doctor whether or not the patient is ready to move on to bracing, which is the next standard practice in scoliosis management.

Bracing

Costs*: USD$2,000-$6,000 for initial bracing and USD$1,000+ a year for X-Rays and doctor visits.

Bracing to correct the body dates back to approximately 650 AD and has developed many variations ranging in materials and treatment. Two types of back braces that limit the motion in the spine are rigid braces and corset braces.

Rigid braces should be well fitted and can limit 50% of the motion in the spine. These are the types of braces used to treat broken bones. Rigid braces tend to be heavy and uncomfortable for patients. Some doctors recommend that the patient wears these when they’re out of bed, but can be removed when lying down.

Thoraco-Lumbo-Sacral-Orthosis (TLSO) - The most common form of a TLSO brace is called the "Boston brace" or an "underarm" brace. This brace is custom molded from plastic and applies three-point pressure to the spinal curvature to prevent its progression. The brace is usually worn 23 hours a day, and it can be taken off to swim or play sports.
Cervico-Thoraco-Lumbo-Sacral-Orthosis - The “Milwaukee brace” is similar to the TLSO brace, but also includes a neck ring. It also is typically worn all day unless the patient is playing sports. This type of brace has been discontinued in many places because it has been seen to cause deformities.
Charleston Bending Brace - This back brace is molded to the patient while they are bent to the side and it used during nighttime to apply pressure and bend the patient against the spinal curve. Some patients would rather wear this brace at night so they can not wear a daytime brace and therefore avoid any negative stigma.

Corset braces (elastic braces) - The brace helps limit motion and prevents the patient from bending forward. This helps set fusion between bones in the back since bones grow better where there is little motion. People with jobs that involve heavy lifting can use these to limit motion and act as a reminder to use proper body posture when lifting.

Negative side-effects of bracing:

Pain
Heat rashes
Skin and bone problems related to pressure from the brace
Adverse effects on the heart and lungs
Psychological trauma from wearing a brace around peers

Psychological trauma should not be underestimated. We all know what it feels like to be different during adolescence, so it’s important to explore alternative options to treat scoliosis.

Precision Spine does not advocate bracing to treat scoliosis

We firmly believe our patients can make a true difference through spinal biomechanics and postural rehabilitation, which is why we do not advocate bracing. Furthermore, using a brace while a patient is undergoing our treatment may actually have an adverse effect since we’re focused on strengthening the same muscles that braces can make weaker.

Surgery

Costs*: USD$113,000 for the surgery then USD$700+ for after care (cane, brace, physical therapy sessions, etc.)

If bracing fails to stop the progression of scoliosis or a patient’s scoliosis is discovered at a stage that’s severe (curves greater than 40 to 45 degrees and continuing to progress and curves that are greater than 50 degrees), doctors typically recommend surgery as the best form of treatment. We feel that scoliosis surgery should be considered the final resort for fixing idiopathic scoliosis, and that it must only be made if all other non-invasive options have been explored.

The goal of the surgery is to use these rods as a temporary splint to hold the spine in place while the bone fuses together to permanently support the spine. It is also important to note that studies have debunked the belief that a patient’s un-fused regions of the spine will become mobile to compensate for the lack of motion. Finally, removal of the rods that are placed in the back during scoliosis surgery is considered a big surgery so they are often left in place unless they irritate the soft tissue around the spine.

There are two approaches to scoliosis surgery:

Scoliosis surgery from the back of the spine (posterior) - A long incision on the back of the spine is made then the muscles are carved out of the spine to allow the surgeon access to the bony elements in the spine. Screws are inserted and rods are used to reduce the amount of the curvature. Bone is then added by taking bone from either the patient's hip or cadaver bone. The hope is that the bones in the back and the bones added will fuse together. The fusion process usually takes about 3 to 6 months, and can continue for up to a year after surgery.

If a patient has a severe deformity and/or a rigid curvature, then a surgeon may recommend a removal of a disc from the front before undergoing scoliosis surgery. Bone is also added to the space where the disc was removed to allow the bones to fuse together.

Scoliosis surgery from the front (anterior) - Depending on the curve, some surgeries can be done from the front of the body. The incision is made at the front of the body and a rib (usually on the right side) is removed. The diaphragm can be released from the chest wall and spine to give the surgeon access to the thoracic and lumbar spinal vertebral bodies.

Discs are removed to loosen up the spine, then screws and rods are put in place to reduce the curvature. Bone from the patient or a cadaver is added to allow the spine to begin to fuse together. Again, the fusion process usually takes about 3 to 6 months, and can continue for up to a full year.

If anterior surgery is applicable for the patient’s condition, it has several advantages when compared to the posterior approach.

Precision Spine believes that scoliosis surgery should be considered the final resort

While scoliosis surgery techniques have improved, many patients feel that the risks and poor treatment outcomes make this a last resort. Like every invasive surgery, the procedure carries very serious risks (permanent disablement, neurological damage, death, etc.). What makes this procedure more worrying is that hardware failure can happen leaving one or more components of the rod placed inside the body.

Many patients primarily undergo surgery as a cosmetic procedure which ultimately leaves their complex condition untreated. That often results in chronic pain, disfigurement, and even long-term disability.