Screening—Clinical examination is recommended and endorsed by the Scoliosis Research Society (SRS), the American Academy of Orthopaedic Surgeons (AAOS), the Pediatric Orthopaedic Society of North America (POSNA) and American Academy of Pediatrics (AAP) twice for females at ages 10 and 12 and once for males at age 13 or 14. School or primary care physicians’ screenings are options. Refer to our steps for detecting signs of scoliosis for a review of a clinical examination. In Georgia, school screening is required in two grades between the ages of 10 and 15.
- Medical observation—Periodic follow-up examinations are the appropriate medical management for curvatures that are less than 15 degrees in skeletally immature patients. A medical provider should evaluate symptoms of pain because it is not an accompanying symptom of small curves. Observation also includes periodic radiographic X-rays and no restrictions on physical activity.
In skeletally immature patients with curves of 15 degrees or more, refer to a pediatric orthopaedic surgeon for evaluation and the development of a treatment plan.
Orthotics—Bracing is provided for curves that are increasing in magnitude during the growth phase. The goal of bracing is to prevent the curve from progressing. The brace type is determined by multiple factors, including curve location and flexibility.
- Surgery—The parameters for possible surgery include curves greater than 45 degrees in skeletally immature patients or greater than 50 degrees after skeletal maturity. The goal of surgical treatment is to prevent curve progression and obtain curve correction.
- Alternative treatments—Chiropractic medicine, physical therapy and yoga can be utilized if they provide physical benefits to the patient, such as core strengthening and symptom relief. Currently, the value of these treatment options, when compared to the standard parameters for medical management in scoliosis, has not scientifically proven to limit curve progression.
Our Scoliosis Screening Program provides case management and tertiary clinics for patients with signs of adolescent idiopathic scoliosis (AIS). Call 404-785-7553 to discuss or refer patients or to schedule an educational in-service.