When is treatment indicated in juvenile idiopathic scoliosis?

Updated: Dec 02, 2020
  • Author: Charles T Mehlman, DO, MPH; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

One potential treatment algorithm for juvenile idiopathic scoliosis is as follows:

  • Observation for curves less than 25° with follow-up radiographs at regular intervals
  • Bracing for curves that range from 25º to 40° and at least consideration of bracing (based on curve flexibility) for curves from 40º to 50°
  • Bracing for smaller curves that demonstrate rapid progression to the 20-25° range
  • Surgical intervention for inflexible curves that exceed 40° or virtually any curve that exceeds 50°.

Bracing and casting may be used outside the above-mentioned parameters in an effort to help control a large curve in a young child for whom the surgeon is attempting to optimize spinal growth. Similar recommendations exist regarding the value of MRI in juvenile idiopathic scoliosis due to a significant rate of neural axis abnormalities. [96]


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