Conservative treatment of scoliosis – 2022


Conservative treatment of scoliosis

No conservative treatment has been conclusively shown to have decisive effects on the course of scoliosis.

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Scoliosis is a deviation of the spine that causes a curve. The severity, prognosis and symptoms will depend on the magnitude of the curve, the age of onset, and the location and characteristics of the lesion.

Scoliosis is a disease that does not have a cure. However, it can be treated to prevent its progression. In children, it is necessary to monitor them until they reach their final growth spurt. Once in adulthood, surgery may be indicated in some cases.

The main symptom of scoliosis is the lateral curvature of the spine in certain areas (thoracic or thoracolumbar), which causes an asymmetry at the level of the ribs and shoulders. In more severe cases, scoliosis can cause respiratory insufficiency and back pain

In therapeutic decisions for vertebral deformities, several factors are considered: the patient’s age, severity and location of the curve, its etiology (causes), and the presence of other associated pathologies. The basic goals of scoliosis treatment are:

  • The control of progression until skeletal maturity, at which time it stops or is considerably limited.
  • The correction of the existing deformity.
  • The avoidance of the local or general consequences of the deformity.
slight curves

Treatment by physiotherapy and swimming. The placement of a corset or a postural corrector is an indication that must be assessed in each specific case.

moderate curves

Treatment may lean toward surgery, or the prescription of a Milwaukee brace.

serious curves

They require arthrodesis (surgical fixation of a joint).

Conservative treatment of scoliosis

No conservative treatment has been conclusively shown to have decisive effects on the course of scoliosis. Some of them, however, help to temporarily correct the curve and, above all, serve to prevent the progression of the deformity in patients who have not yet reached skeletal maturity and have aesthetically acceptable curves.

The most popular method is the Milwaukee corset, which is based on the corrective principle of support in three areas: a cervical area, a pelvic area, and an intermediate thrust immediately below and behind the costal area. The three zones are connected by longitudinal bars, to which the necessary straps are attached to exert pressure. The corset must be used, in principle, for 23 hours a day (the rest of the day is used for cleaning) and maintained until X-ray verification of skeletal maturity.

The limitations of corsets for the treatment of scoliosis are:

  • They attempt correction through forces of limited magnitude, as they would otherwise lead to pain and pressure ulcers.
  • These forces are applied at an excessive distance from the deformity and on soft tissues.
  • They do not take into account the three-dimensional character of the curve.
  • Rarely do patients (in a particularly sensitive phase of their affective, relational and physical activity) maintain the required discipline in the use of the corset.

Surgical treatment of scoliosis

Este tipo de tratamiento permite:

  • Stop the evolution of the curve.
  • Correct it in variable proportion, depending on various characteristics of it.
  • Maintain the correction obtained over time, thus avoiding the late repercussions of the deformity.

To properly achieve these objectives, the surgical technique used is complex, bloody, prolonged, and not without risk, although current procedures offer very satisfactory results. The basis of treatment is obtaining a solid spinal arthrodesis of the affected segments, at least in the position of greatest possible correction.


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