DEAR MAYO CLINIC: My 10-year-old daughter was just diagnosed with scoliosis. The curve is 19 degrees, and I've read that it could get worse with time. Will she need to wear a brace?
It sounds like your daughter's case of scoliosis is mild. At this time, it probably does not need treatment. But you are correct that scoliosis can progress over time. If it does, your daughter may need to wear a brace to keep the curve from getting worse.
Scoliosis is an abnormal sideways curvature of the spine. Most people have a spine that is relatively straight. In general, a spine with a 10-degree curve or less is considered normal. A curve greater than 10 degrees is defined as scoliosis.
The goal of scoliosis treatment is to keep the curve from getting worse. Treatment options depend in large part on the curve's severity. Curves between 10 and 25 degrees -- where your daughter's case fits -- are in the mild range. Between 25 and 50 degrees is the moderate range, and greater than 50 is severe.
Other factors to take into consideration when deciding on scoliosis treatment include a child's gender -- girls have a much higher risk than boys of the curve getting worse -- as well as the location and pattern of the spinal curve.
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Severe scoliosis almost always can benefit from surgical treatment. The most common type of scoliosis surgery is spinal fusion. It involves connecting two or more of the bones in the spine together, so they can't move independently.
Occasionally, patients with moderate scoliosis also may benefit from surgical treatment. But for most of them, brace treatment is recommended to prevent the curvature from progressing.
A scoliosis brace is made of plastic materials and is contoured to conform to the body. It is a close-fitting brace and goes unnoticed under most clothing, as it fits under the arms and around the rib cage, lower back and hips.
Braces work by pushing on the muscles and bones attached to the spine. This holds the spine in place, preventing it from curving more. Because a brace's effectiveness increases with the number of hours it is worn, most children wear their braces day and night. Even with a brace, they can usually participate in activities and have few restrictions.
Many children who have a mild curve, such as your daughter, don't need a brace or surgery. Instead, she will likely have regular follow-up appointments with her doctor, about every six months, to check for any evidence that the curve may be getting worse.
If at some point her curve crosses the line from mild to moderate severity at about 25 degrees, then a brace may be necessary. Braces only work to treat scoliosis in children who are still growing. For most kids, that means brace treatment typically is no longer an option after about age 16. But once a child stops growing, it is also unlikely a spinal curve will progress any further.
Talk to your daughter's doctor about her diagnosis and her risk of the spinal curve becoming worse. Arrange a schedule of checkups so you can catch any changes early. Talk to your daughter, too, about how she's feeling. Coping with scoliosis can be difficult for pre-teens and teens. Support and encouragement from family and friends can help. -- Anthony Stans, M.D., Orthopedic Surgery, Mayo Clinic, Rochester.
Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. Email a question to medicaledge@mayo.edu. For more information, visit www.mayoclinic.org.
