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Q
Surgery for Scoliosis?
Are there any alternatives to back surgery for teen-age scoliosis?
A
Answer (Published 3/21/2005)

Scoliosis is a sideways curve of the spine, either "S" shaped or "C" shaped. This disorder occurs most frequently in girls over the age of ten. Although scoliosis does run in families, in the vast majority of cases, the cause is unknown. Doctors usually can make a diagnosis by physical examination, checking to see if the shoulders are level, the head is centered and opposite sides of the body look level. An x-ray may be needed for correct measurement of the curve.

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All told, some degree of scoliosis affects about two percent of the population. Very mild curves don't require any type of treatment. The Scoliosis Research Foundation estimates that only 10 percent of people with scoliosis - those with curves greater than 20 degrees - need treatment of any type. Orthopedic spine specialists are the physicians who usually treat patients with scoliosis.

When a child is still growing and the curve is less than 25 degrees, all that may be required is a checkup every four to six months to see whether or not the curve is worsening. If it is - or if it was greater than 25 degrees to start with - a customized back brace may be recommended. Patients wear the brace daily for a specified number of hours (often between 18 and 20 per day). Among youngsters and teens who are still growing, surgery is considered necessary only for very severe curves - those that are 45 degrees or more and worsening.

Alternatives to surgery include osteopathic manipulation and therapeutic yoga, which can help lengthen and strengthen the muscles that support the spine. Depending on how severe the scoliosis is, breathing practice and training may prove helpful. Some skilled osteopathic physicians I've worked with believe that asymmetrical breathing - that is, expansion of one side of the chest than the other - may be an underlying cause of scoliosis. That is easily corrected, if it is noticed, both by manual (manipulative) medicine and breathing practice.

Andrew Weil, M.D.

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