Scoliosis and kyphosis are two types of curvature of the spine, from side to side or from front to back, respectively. Scoliosis may occur in the upper (thoracic) or lower (lumbar) spines or in both. Although curvatures of the spine may be present at birth, may occur during growth years or may develop in adulthood, treatment options are similar and limited to a handful of methods.
Back Bracing
Back bracing treats scoliosis by positioning a rod outside of the body to hold the spine in position at all times and prevent any additional curvature from developing, especially during teenage growth years. Scoliosis is measured by degrees of curve on an x-ray image, and curves greater than 25 degrees are often candidates for back bracing. However, a report in 2010 by the Italian Scientific Spine Institute revealed that bracing did not effectively reduce curvature progression in most of the approximately 300 patients observed in two studies, possibly because of poor compliance by the patients. The exact usefulness of back bracing, therefore, is still undetermined.
Back Surgery
In patients whose curves are more severe, such as those with curves greater than 40 degrees, back surgery may be necessary to halt the curve progression, reduce some extent of the existing curvature and improve quality of life. Surgery options vary, but all techniques include addition of rods and pins to specific areas of the spine to hold the bones in one place, at times even to fuse parts of the curved spine together. Although these surgeries are effective, an important side effect can be limited mobility of the back and spine afterward.
Exercise and Observation
One decision doctors, parents and children with scoliosis must make, especially when curvatures are nearing 25 degrees, is whether to proceed with treatment interventions like bracing or surgery or whether to watch and wait. Observation of the curvature involves regular x-rays and office visits to measure how quickly the curve increases, in particular when associated with a growth spurt and older age, because curves often slow progression, or even stop, in adult years. In conjunction with observation are spinal exercises that strengthen the muscles around the curve, both in the back and in the hip, rib or chest areas that support the spine. Exercises to encourage strong muscle support are a useful way to improve quality of life in any person with a curvature of the spine.
