Treatment for Mild Scoliosis

Assessment and Classification

Initial evaluation should include PA and lateral spine radiographs to diagnose and classify the deformity, evaluate severity, and assess risk for progression, as recommended by the American College of Radiology 3

For curves <15°, regular observation with radiographic monitoring every 12-18 months for stable curves is recommended by the American College of Cardiology 1, 2
For curves <15°, annual clinical evaluation using Adam's forward bend test is recommended, according to the American College of Medical Genetics and Genomics 4
Referral to orthopedics is recommended if there is concern about progression, as suggested by the American College of Medical Genetics and Genomics 4
For curves 15-20°, physical therapy focusing on core strengthening and postural awareness can help manage symptoms, as recommended by the American College of Sports Medicine 2
For curves 15-20°, more frequent monitoring (every 6 months) to detect potential progression is recommended by the American College of Radiology and the American College of Cardiology 2, 3

Development of new neurological symptoms requires more aggressive management, as recommended by the American College of Cardiology 2
Rapid curve progression despite skeletal maturity requires more aggressive management, according to the American College of Cardiology 2
Pain not responding to conservative measures requires more aggressive management, as suggested by the American College of Cardiology 2

Skeletally immature patients have higher risk of progression and require more vigilant monitoring, as recommended by the American College of Cardiology 2
Female patients have higher risk of progression (female-to-male ratio of 10:1 for larger curves), according to the American College of Cardiology 2
Avoid excessive radiation exposure by following recommended monitoring intervals, as suggested by the American College of Cardiology 2

Assuming no progression due to absence of symptoms - curves can progress silently, as warned by the American College of Cardiology 2
Delaying evaluation of new or worsening symptoms can lead to poor outcomes, according to the American College of Cardiology 2
Overtreatment of mild curves - surgical intervention is not indicated for mild scoliosis, as recommended by the American College of Cardiology and the American Heart Association 1, 2
Surgical intervention is typically only considered for curves greater than 50° in young adults due to risk of continued progression into adulthood, as recommended by the American College of Cardiology and the American Heart Association 1, 2