Observation

One traditional approach to scoliosis has been the “wait and see” method of observation. This often happens when a scoliosis is detected in a young child, but the curve is not large enough to recommend traditional treatments such as hard bracing or surgery. A doctor or surgeon will periodically monitor the progression of the curve to see if it gets severe enough to do something about.

Observation makes sense when the only treatment options are invasive such as surgery. However with the availability less invasive treatments such as SpineCor bracing, the ScoliBrace and SEAS and Schroth physical therapy the opportunity for earlier intervention now exists.

The discussion of observation vs. intervention revolves around the ability to be able to predict progression and having an effective treatment that can be used early on. Progression prediction is complicated and involves different factors such as age, curve magnitude, curve location, maturation, family history and a range of other factors. Currently there are two genetic test under trial that may offer some insight into the strength of the genetic component of the progression. In the future this may lead to a situation where observation and early intervention are selectively chosen based on these test results.

In the absence of these tests we can look to the research on curve progression and curve magnitude at different ages. In 1984 Lonstein and Carlson reviewed 727 children with idiopathic scoliosis. In there study they found that there was a “direct relationship between the incidence of progression and the magnitude of the curve, and an inverse relationship with chronological age and Risser sign”. In other words a larger curve in a younger, less mature child was more likely to progress than a smaller curve in an older, more mature child.