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Severe scoliosis is a spinal curvature measuring 45° or more (some sources use the 50º threshold) according to Cobb angle as measured on an AP/PA scoliosis x-ray. Often, patients with severe scoliosis were initially diagnosed with a milder curve that has progressed over time. Occasionally, however, scoliosis can go undetected, until it reaches a more severe level or it can come on suddenly. At that point, postural asymmetries (for example, at the shoulders, ribcage, or hips) can become more apparent. Because of increased asymmetric spinal loading, severe scoliosis is also more likely to continue to progress than smaller scoliosis curves. For this reason, severe scoliosis treatment is necessary, especially in growing adolescents.

Surgery for Severe Scoliosis Treatment

When scoliosis begins approaching or enters the severe stage, orthopedic surgeons will typically begin discussing the possibility of surgery with you and your child. While surgery is often presented as the only option, it’s worth getting a second opinion or investigating conservative treatment options. Scoliosis surgery poses a risk for complications and the need for revision surgery later on in life. One study puts the revision rate for surgery as high as almost 50%. Scoliosis surgery is typically more successful in children/adolescents rather than in adults. That said, in some very severe cases of scoliosis, surgery is necessary. 

However, in the majority of cases it is possible to manage scoliosis conservatively if you/your child are motivated to avoid surgery. Consider for example, long-term natural history studies that say that people with scoliosis can live a long and healthy life even if untreated. Weinstein et al. found no evidence to link untreated late-onset idiopathic scoliosis (AIS) with increased mortality. Only patients with thoracic curves of more than 100° are at increased risk of death from cor pulmonale and right ventricular failure. For patients seeking to halt progression and/or decrease symptoms of scoliosis (i.e. postural asymmetries, muscular imbalances, fatigue, pain, etc.), non-surgical options are available. 

Severe Scoliosis Treatment at Scoliosis 3DC

At Scoliosis 3DC, we have a two-pronged approach for severe scoliosis treatment to help patients work to manage their curve(s). Protocols include highly corrective scoliosis bracing (Cheneau-Gensingen brace) and Schroth scoliosis exercise (Schroth Best Practice). The Cheneau-Gensingen brace has the potential to help curves measuring 40° and higher, especially when there is growth opportunity. Historically, scoliosis braces have not been designed to address Cobb angles that fall into the severe scoliosis category. For years, doctors have insisted that other than surgery, there is little that can be done to address severe scoliosis.

Severe Scoliosis Treatment Results

As with scoliosis at a mild or moderate phase, brace treatment starting at a low bone age (i.e. Risser/skeletal maturity) offers the best hope for treatment outcome. While remaining growth poses a progression risk, remaining growth can also be taken advantage of for some degree of correction. However, results are also based on individual factors and curve reduction is not guaranteed. Please look through our severe scoliosis treatment results section, sub-divided into curves measuring between 45°-54° and ≥55°. We’ve had several juvenile and adolescent patients achieve considerable improvement utilizing the Cheneau-Gensingen brace and Schroth Best Practice exercise program.

Result: KR

  • 13.9 year-old female
  • Initial Cobb angle(s): 50°/50°
  • Risser 0

When this adolescent Toronto patient was diagnosed with a severe double scoliosis, she was told by her surgeon that she would need scoliosis surgery in 6 months. Not satisfied with… Read More

Result: SJ

  • 12-year-old female
  • Initial Cobb angles 53º/71º
  • Risser 3

A school nurse first detected scoliosis in this NY patient. Her family then consulted with doctors who made the official diagnosis of 53° and 71° scoliosis curves. The doctors recommended… Read More

Result: MN

  • 9-year-old female
  • Initial Cobb angles 46º/28º
  • Risser 0

Despite chronic lung issues from an early age that are complicated by juvenile scoliosis, this young patient keeps up amazingly well with other kids her age. According to one doctor’s… Read More

Result: KS

  • 14-year-old female
  • Initial Cobb angles 58º/25º
  • Risser 4

This California girl had worn a SpineCor brace for more than eighteen months, for 18-20 hours a day, and still progressed. She was already a Risser 4 when she came… Read More

Result: JB1

  • 12-year-old female
  • Initial Cobb angles 45º/26º
  • Risser 1

This patient, an avid dancer, was initially diagnosed with scoliosis at 8 years old. When she first came to see us, she was twelve years-old and her Cobb angles measured… Read More

Result: BS

  • 13-year-old male
  • Initial Cobb angles 69º/34º
  • Risser 2

This Florida boy presented with severe scoliosis. His parents are opposed to surgery so they called us and arranged to bring their son for our Schroth Best Practice® program and… Read More

Result: TE

  • 13-year-old female
  • Initial Cobb angles 50º/30º
  • Risser 3

NY Surgeons recommended immediate spinal fusion surgery for this thirteen-year-old CT girl with Cobb angles of 50º and 30º. Instead, her parents brought her to Scoliosis 3DC. Dr. Marc fit… Read More

Result: AK

  • 12-year-old female
  • Initial Cobb angles 62º/30º
  • Risser 0

Reducing scoliosis without surgery is impossible, right? Not for AK, who had just turned 12 when a 49º scoliosis was detected from an x-ray for pneumonia. One month later, her… Read More

Result: CH1

  • 14.5-year-old female
  • Initial Cobb angles 50º/37º
  • Risser 5

This patient with severe scoliosis came to us after a recommendation for surgery. Hers is a wonderful result, especially considering that she was 4 years past menses and at Risser… Read More

Result: EG

  • 47-year-old female
  • Initial Cobb angles 44º/55º
  • Risser 5

Adult scoliosis can present a variety of challenges. We discourage adults from expecting to improve scoliosis. That said, our patient EG is an adult diagnosed with scoliosis in adolescence who… Read More

What Scoliosis 3DC Patients Are Saying

A Friend in Our Battle

“We had hoped for an improvement of a few degrees at best, but this improvement left us stunned. Marc’s knowledge, encouragement and support have given our son the tools to succeed in his battle against scoliosis.” Read More