When a child is initially diagnosed with idiopathic scoliosis, parents are faced with the many choices as to treatment direction they should take.
Often within the UK and the NHS, “watchful waiting” is prescribed. This observation can sometimes be the right approach depending on the child’s age, severity of scoliosis and risk of progression. Examples of this are in small curves that are of low risk of progression and in large curves at high risk of progression that will eventually require surgical intervention.
The problem with “watchful waiting” is that it is never possible to exactly predict how progressive a scoliosis will be. During growth spurts, a curve can go from being only mild to significant in only a few months and require immediate attention. When the right type of treatment is given to a child during growth, it helps to ensure that the child has a better chance of growing in the right alignment rather than just waiting for the curve get worse.
The likelihood of scoliosis progression is linked to the age of onset/diagnosis, curve size and location, family history, maturation and amount of growth left. The larger the curve and younger the child the higher the risk of progression.
It is important to determine the potential risk of progression, so the right treatment can be given. We don’t want to over treat by prescribing a brace in an adolescent with a curve unlikely to progress, when scoliosis specific exercise could suffice. Likewise, we don’t want to under-treat in a 10 year old with high risk of progression.