Scoliosis

About Scoliosis

Scoliosis is an abnormal curvature in the spine and reported to affect approximately
2-3 out of every 100 people.

The most common type of scoliosis is known as Adolescent Idiopathic Scoliosis
(AIS) which develops during the adolescent growth spurt and accounts for around
85% of scoliosis cases. The greatest risk of scoliosis progression is whilst the child
still growing.

Signs and symptoms can include:

• One shoulder blade that is higher than the other
• One shoulder blade that sticks out more than the other
• Uneven hip height or leg length
• A rotated spine with one side more prominent than the other
• Back pain

There is currently no screening in the UK for this condition, however, it has been
suggested that screening could help detect the condition at an earlier stage where
non-surgical treatment may prevent the scoliosis from worsening.

The UK National Screening Committee reviewed the decision not to screen for
scoliosis in July 2016, citing the following reasons for not recommending national
screening:

• No evidence based age at which to offer screening
• Further test requires x-ray, exposing people to radiation
• Unclear whether treatment is better than waiting for symptoms to develop

We believe that early identification and intervention can allow for effective non-surgical treatment of scoliosis.

The Adam’s Forward Bend Test can be used to screen for scoliosis and can be
carried out by the parent or carer if they are concerned that their child may have
scoliosis. For this test, the child is asked to link their hands together in front of them
and bend forward to around 90 degrees at the waist. If curvature of the spine is
present, one side of the upper back will be visibly higher than the other.

Why Treat Scoliosis Non-Surgically?

• Pain prevention
• Progression may lead to further related health problems
• To allow continued participation in physical activities and hobbies
• Improved cosmetic outcomes
• To avoid the risks of major surgery

Treatment recommendations depend on a number of indicators which influence the
progressive factor for each specific case of scoliosis. These include age, cobb angle
and Risser sign.

If the curvature is less than 20°, scoliosis specific physiotherapy along with
observation is typically recommended to monitor the curve progression.
For curves greater than 20°, orthotic bracing in conjunction with scoliosis specific
physiotherapy can provide biomechanical correction and prevent worsening of the
curve.

Some literature suggests that once the curve is greater than 45°, surgery may be
considered, however there is little evidence of the benefit and long term efficacy of
spinal surgery. There is increasing evidence to show the CMP Brace® can still be
effective for these larger curves.