What Is the Treatment for Scoliosis?

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What Kind of Doctor Treats Scoliosis?

The right scoliosis specialist depends on the patient’s age and the type of curve:

  • Children and teens: A pediatric orthopedic surgeon who specializes in spine conditions
  • Adults: An orthopedic spine surgeon or a physiatrist (a nonsurgical doctor focused on physical medicine and rehabilitation)

Because scoliosis affects posture, muscles, and sometimes breathing, care often involves a team, which may include:

  • A spine specialist (doctor or surgeon)
  • A physical therapist
  • An orthotist (if bracing is needed)

Seeing a surgeon does not mean surgery is necessary. Mild curves are often monitored over time, and many children only need observation or bracing. Surgery is reserved for cases where the curve continues to worsen despite treatment.

What Is the Treatment for Scoliosis?

Scoliosis treatment depends on:

  • The patient’s age
  • The cause of the scoliosis
  • The size and progression of the spinal curve

Treatments fall into two categories:

  • Nonsurgical care (observation, physical therapy, bracing, casting)
  • Surgical correction (for advanced or progressive curves)

Below is an easy guide to how scoliosis is managed at different curve sizes.

Mild Curves (Less than 20–25°)

Nonsurgical Treatment

Most mild curves do not require active treatment. The focus is on careful monitoring to ensure the curve does not worsen during growth.

Observation & Monitoring

  • Visits every 4–6 months
  • Routine X-rays or EOS scans
  • Tracking changes in posture and curve progression
  • Referrals to other specialists if needed

Physical Therapy

Physical therapy may be recommended to:

  • Strengthen the core and back muscles
  • Improve posture
  • Reduce discomfort
  • Support long-term spinal health

Schroth Method–based therapy is the most common approach, using customized exercises and breathing techniques to help improve spinal alignment.

Moderate Curves (25–45°)

Nonsurgical Treatment: Bracing

Bracing is recommended for growing children with moderate curves. The goal is to stop the curve from getting worse, not to straighten the spine.

Key points:

  • Works best when detected early
  • Can prevent surgery in many cases
  • Usually worn 18 hours a day, though some children use a night-time brace
  • Different brace types are chosen based on curve pattern
  • Flexible braces may be used for single-curve scoliosis

Casting may be used for very young children when a removable brace cannot control the curve. Casts are changed every few months and often require anesthesia for comfort.

Severe Curves (Greater than 40–50°)

Surgical Treatment

Surgery is usually recommended when:

  • Bracing cannot stop curve progression
  • The curve continues to worsen
  • The curve is large enough to cause imbalance, pain, or reduced lung space

The goal of surgery is to:

  • Stop the curve from progressing
  • Improve spinal alignment
  • Enhance long-term function and quality of life

Below are the most common surgical options:

Spine and Rib-Based Growing Rods

Used for young children who are still growing.

  • One or two rods are placed along the spine
  • The child returns every 6 months for rod lengthening
  • Final spinal fusion is performed once growth is complete

Vertebral Body Tethering (VBT) – Fusionless Surgery

A newer option for children who are still growing and have flexible curves under 35°.

  • A strong cord (tether) is attached to the outer side of the curve
  • Slows growth on that side so the spine straightens as the child grows

Hemi-Epiphysiodesis

Used mainly for congenital scoliosis, where bones forming the spine are asymmetrical.

  • Slows growth on one side of the spine
  • Allows the opposite side to grow and gradually correct the curve

Hemivertebra Resection

For young children with severely misshaped vertebrae (hemivertebrae).

  • Removes the abnormal bone
  • Fuses the surrounding bones in a corrected position

In Situ Spinal Fusion

Stops progression by fusing vertebrae “as they are.”

  • Typically used for early, rapidly progressing curves
  • Provides stability with minimal correction
  • Bracing or casting may be needed during healing

Spinal Fusion (Traditional Correction)

For major curves in older children, teens, and adults.

  • Removes joints between vertebrae
  • Uses bone grafts to fuse them into a solid, stable structure
  • Rods and screws may be added for additional correction
  • Helps restore alignment and prevent long-term progression
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