← Neuromuscular Scoliosis: A Guide for Families
There are four options: observation, bracing, wheelchair modification and spinal fusion surgery. The three non-surgical options do not stop the curve from getting bigger. Only surgery can.
Observation
Carrying on with what you're doing now, with regular check-ups.
Bracing
Wearing a firm moulded plastic brace around the upper body.
Wheelchair modification
The wheelchair clinic shapes the seat and trunk supports to your child's curve size and location.
What do the non-surgical options offer?
Benefits | Observation | Bracing | Wheelchair modification |
Avoids the risks of surgery | ✔ | ✔ | ✔ |
Better trunk support | ✔ | ||
Better sitting posture | ✔ | ||
More comfortable sitting in the wheelchair | ✔ | ||
Same benefits as a brace, with less discomfort and no time spent putting it on | ✔ |
Risks | Observation | Bracing | Wheelchair modification |
Sitting gets harder as the curve grows | ✔ | ✔ | ✔ |
Breathing gets harder as the curve grows | ✔ | ✔ | ✔ |
Breathing difficulty caused by the brace | ✔ | ||
Pain increases as the curve grows | ✔ | ✔ | ✔ |
Care gets harder as the curve grows | ✔ | ✔ | ✔ |
Doesn't straighten the curve | ✔ | ✔ | ✔ |
Doesn't stop the curve getting bigger | ✔ | ✔ | ✔ |
Spinal fusion surgery
- In general, curves under 50 degrees can be treated with observation if your child has no symptoms. Symptoms can be managed with bracing or wheelchair modification
- When the curve reaches 50 degrees, whether there are symptoms or not, the risk of it growing is high and surgery becomes an option. In Duchenne muscular dystrophy, surgery may be offered when the scoliosis is a little less severe, because these children tend to have lung problems that may prevent surgery later
- Waiting to see if problems develop may not be a safe option. Curves become more difficult and risky to treat as they get bigger. Surgery is less complicated in the early to mid teens, when the spine is more flexible and easier to treat with a metal rod
- Spinal fusion is the only treatment that can make the curve smaller and keep it from growing again
- Surgery can be expected to make the curve 50 to 75 percent smaller. For example, a 60 degree curve may be 30 degrees or less afterwards