Severe Scoliosis

What is severe scoliosis?

By definition, severe scoliosis (referred to as third degree scoliosis in some countries) is a spinal curvature (Cobb angle) at or above 50º.

I have severe scoliosis. Do I need spinal fusion surgery?

Every individual is different, but at Scoliosis3DC℠ we only endorse surgical intervention in very extreme cases, and we aren’t referring to those with 60º or even 70º curves. The reason for this is it has been determined that individuals with scoliosis can live a long, healthy life without treatment (1) (we don’t recommend that, we recommend taking a proactive stance). In fact, it has been determined by two prominent scoliosis surgeons that evidence is lacking for scoliosis surgery (2). Finally, it’s important to know the many risks and unknowns when it comes to surgery, both in the mid- and long-term (3).

At Scoliosis 3DC, we’ve treated patients with very severe scoliosis successfully in terms of helping some achieve curve reduction, improve pain and/or increase vital capacity.  (Please see our Schroth Method Results page for a few results).

For adolescent idiopathic scoliosis (AIS), we encourage parents to bring their adolescents for Schroth Best Practice® instruction as early as possible in the process after a diagnosis. When scoliosis is severe, we recommend our intensive Schroth immersion program and the Chêneau-Gensingen® Brace because it’s the best scoliosis brace to successfully manage curves with Cobb angles of 50º, 60º and higher.

Other than surgery, what can be done for severe scoliosis?

Scoliosis surgery is usually done for cosmetic reasons and to prevent further progression, but Schroth exercises and/or bracing can help with both of those as well.  Our patients improve postural appearance, stimulate spinal stabilization and improve muscle imbalances without surgery. Patients are taught how to  avoid curve-stimulating behaviors on their own. Practice can help improve vital capacity and reduce pain. It’s important to know that the the foremost natural history study on scoliosis (1) states that the incidence of back pain for people with scoliosis is only somewhat greater than the general population. Patients who gain the skills we teach learn how to help alleviate pain and progression, without surgery.


 

1 – Weinstein: Health and Function of Patients With Untreated Idiopathic ScoliosisA 50-Year Natural History Study

2 – Westrick ER, Ward WT. Adolescent idiopathic scoliosis: 5 year to 20-year evidence-based surgical results. J Pediatr Orthop. 2011;31(1 Suppl):S61–S68.

3 – Mueller FJ, Gluch H. Cotrel-dubousset instrumentation for the correction of adolescent idiopathic scoliosis. Long-term results with an unexpected high revision rateScoliosis. 2012;7(1):13. doi: 10.1186/1748-7161-7-13.