Scoliosis and kyphosis can be detected through physical assessment. The first scoliosis signs are often postural, for example, an uneven tilt of the shoulders or one side of the rib cage protruding more than the other. A thorough postural assessment by a clinician, including the Adams forward bending test, is usually enough to determine if further assessment is required which usually includes an X-ray.
An X-ray is the only way to accurately diagnose and measure a scoliosis (or kyphosis). Only standing X-rays should be used as they show the true degree and alignment of the curve or curves while the patient is upright. Lying down X-rays are not as useful as the spine can be mispositioned and the true extent of the scoliosis minimized.
Once X-ray images have been taken, a type of measurement called the “Cobb angle” is used to assess the degree of the scoliosis. It is critical that any health professional assessing scoliosis is familiar and accurate with this measurement as it is then used to form recommendations for treatment options based on the degree of curve. For children, an X-ray is also fundamental to assess the bone age which gives the clinician useful information regarding future spinal growth and the risk of curve progression. In older adults, X-rays also play an important role in assessing spinal balance and the presence of any spinal instability.
A scoliosis is a curve over 10 degrees “Cobb angle” with visible rotation of the vertebrae. If no rotation is seen on the X-ray, the curve is not a true scoliosis and may be postural or positional.
In part, scoliosis treatment options, and the prognosis of future worsening of the curve, relate back to the size of the curve as measured on an X-ray. For example, in children when curves are small, ie. less than 20 degrees, scoliosis specific exercises or part-time bracing may be treatment options. If a curve is larger and measures more than 35 degrees, scoliosis exercises alone are not recommended and full-time scoliosis bracing is nearly always advised as the primary treatment. In severe cases where curves are greater than 60 degrees, surgery may be the best approach to treatment.
ScoliCare’s approach to scoliosis treatment is to ensure each curve is accurately assessed from the outset and that we provide appropriate non-surgical treatment options tailored to each patient or recommend surgery if necessary.
We’d like to thank our patients for their permission to use their images and results in our case studies. These studies are not to be reproduced without written permission from ScoliCare.
Female aged 88 years with a degenerative de novo scoliosis because of earlier spinal trauma many years earlier. Improvement of a severe post-traumatic de novo degenerative scoliosis using 3D designed custom scoliosis brace in an older female Summary: This case details the successful management using a a 3D designed custom…
Female aged 87 years with adult degenerative scoliosis. Treatment of a severe scoliosis using a 3D designed custom scoliosis brace in an Older Female Patient Summary: This case details the management of an older female with Adult Degenerative Scoliosis using a 3D designed custom scoliosis brace. The patient initially presented…
Female aged 14 years with a 34° thoracolumbar curve. Reduction of Severe Scoliosis using a 3D Designed Custom Scoliosis Orthosis in a Young Active Female Summary: This case details the successful management of a young active female with adolescent idiopathic scoliosis (AIS) using a using a 3D designed custom scoliosis…
