Treatment in children - Scoliosis

If your child has scoliosis, the recommended treatment will depend on their age, how severe the curve is, and whether it's getting worse.

Many children will not need treatment, and only a small number end up having surgery.

There is a separate page about treatments for scoliosis in adults.

Monitoring

Treatment is not always necessary for very young children because their spine may straighten as they grow.

But if the curve does not correct itself, there's a small risk it could reduce the space for the organs to grow, so careful monitoring by a specialist is important.

Your specialist may recommend regular examinations and X-rays to monitor the curve and decide if treatment is needed.

Regular monitoring may also be recommended for older children with mild scoliosis, as treatment might not be needed if it's not getting worse over time.

Wearing a cast

In babies and toddlers, treatment to try to help straighten the spine as it grows may be recommended.

This may involve wearing a plaster cast fitted around their back.

The cast is worn constantly and cannot be removed, but it's changed every few months as your child grows.

Parents often find it easier for their child to wear a cast while they're still very young, rather than getting them to wear a removable back brace every day.

A removable back brace may be recommended once your child grows older.

Back braces

If the curve of your child's spine is getting worse, your specialist may recommend they wear a back brace while they're growing.

This will not correct the curve, but might help stop it getting worse. There are still some uncertainties about how well braces work so they're not recommended by all scoliosis specialists.

The brace:

• will be custom-made to fit your child's body
• will normally be made of rigid plastic, although flexible braces are sometimes available
• is designed to be difficult to see under loose-fitting clothing
• usually needs to be worn for 23 hours a day
• should not interfere with most everyday activities – it normally only needs to be removed for baths, showers, swimming and contact sports

Your child will usually have to wear the brace for as long as they're growing.

Scoliosis Support & Research has more information about bracing.

Surgery

Surgery may be recommended if your child's scoliosis continues to get worse despite trying other treatments, or if they have severe scoliosis and they've stopped growing.

The type of surgery offered will depend on your child's age.

Surgery in children

Younger children – generally those under 10 – can have an operation to insert special rods alongside the spine. This can help stop the curve getting worse as the spine grows.

After the operation, your child will need to return to their specialist every few months to have the rods lengthened to keep up with their growth.

Depending on the type of rods used, this will be done either:

• during a minor procedure where the rods are extended through a small cut (incision) in the back
• using a remote control that activates magnets inside the rods – no incisions are needed to lengthen these rods

Even if they have surgery, your child may need to wear a brace to protect their back.

When they stop growing, the rods can be removed and a final operation to straighten their spine may be carried out.

Surgery in teenagers and young adults

Teenagers and young adults who've stopped growing can have an operation called a spinal fusion to correct the curve.

This is a major operation where the spine is straightened using metal rods, screws, hooks or wires, along with bits of bone taken from elsewhere in your body, often the hip.

These are usually left in place permanently.

Most people:

• spend about a week in hospital after the operation
• can return to school after a few weeks
• can play sports after a few months – although they may need to avoid contact sports for longer

Sometimes they'll need to wear a back brace after surgery to protect the back while it heals.

Risks of surgery

Like any operation, spinal surgery carries a risk of complications. It will only be recommended if your child's surgeon feels the benefits outweigh the risks.

Some of the main risks include:

• bleeding – if this is severe, your child may need a blood transfusion
• wound infection – this can usually be treated with antibiotics
• the rods or metalwork moving or the grafts failing to attach properly – additional surgery may be required to correct this
• in rare cases, damage to the nerves in the spine – this can lead to permanent numbness in the legs, and can sometimes cause paralysis of the legs and loss of bowel and bladder control

Make sure you discuss the potential complications with your surgeon.

More information

• Scoliosis Support & Research: surgery in young people (adolescent idiopathic scoliosis surgery)
• Scoliosis Support & Research: preparing your child for surgery
• Scoliosis Support & Research: advice for before and after surgery

Exercise and other therapies

Regular exercise is important for children with scoliosis. It can help improve muscle strength and may help reduce any back pain.

Children with scoliosis can usually do most types of exercise. They only need to avoid certain activities if advised to do so by a specialist.

It's not yet clear whether specific back exercises or physiotherapy can help improve scoliosis, and they're not recommended by all specialists.

There's currently little reliable evidence to suggest that other therapies, such as osteopathy and chiropractic, can help correct a curved spine or stop it getting worse.