What is scoliosis?
To better understand scoliosis, we should first understand how the normal spine looks like.
For the most part, we don’t know what causes scoliosis, and researchers estimate that about 80% of all scoliosis is of unknown cause. That’s why, most of scoliosis are called “idiopathic”, which means “unknown cause”.
When looking into the body from the front (frontal plane), scoliosis can appear as “S” shaped or “C” shaped. This unique morphology is linked with scoliosis specific signs, which include:
- Uneven shoulders
- Uneven waist
- Uneven hips (pelvis) where one hip seems higher
- One side of the back sticks out
- One shoulder blade sticks out more than the other
- One side of ribs on the front stick out more than the other
Treatment for scoliosis
- Physiotherapeutic scoliosis specific exercises (PSSE)
The goal of observation during adolescence is to monitor the progression of the curve, while PSSE aims to prevent progression and improve the appearance and the quality of life; the goal of bracing is to prevent curve progression; and the goal of surgery is to correct the curve as much as possible.
Observation is recommended for children with curves less than 25° who are still growing and for patients with curves less than 50° who are done growing. Observation consists of monitoring patients for progression, but with no specific treatment applied. This treatment for scoliosis is also known as “watchful waiting”. The International Society on Scoliosis Orthopedic Rehabilitation Treatment (SOSORT) 2016 Guidelines recommends physiotherapy scoliosis-specific exercises, such as the Schroth exercises for patients with curves <35° to prevent further progression of the deformity, its consequences and, the need for bracing or surgery. Bracing is standard for growing children with curves between 25° and 45° to prevent the curve from progressing. Surgery is recommended for patients whose curves are greater than 45° while still growing or greater than 50° when growth has stopped to prevent curve progression and/or obtain curve correction.
PSSE, such as the Schroth method, has been shown to improve scoliosis outcomes both when applied as a standalone therapy as well as in combination with bracing. It is also known that the scoliosis specific exercises help reduce the correction loss in brace during weaning.