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Question of the Month

March 2020


Question:

My 14-year-old daughter was just diagnosed with dorso lumbar scoliosis with a 46 curve. We were given two different doctor's opinions. 1) She needs to wear a brace since the curve is less than 50% and she is only 14. 2) She needs surgery within the next 12 months to correct the curve since it's in the high range (46 degrees) and she is still growing. We are lost and not sure what to do. Could you please provide us with your assessment?

- Algeria (Parent)


Answer:

Having to decide how to proceed with Scoliosis treatment can be very difficult for parents. Especially as there is no right or wrong answer. Without seeing your daughter and her body shape as well as knowing her bone age (all 14 year old are different) it would be difficult to give hard recommendations. Even so at 46 degrees surgery is not mandatory. I would recommend waiting to see if it continues to progress. There is no difference in operating on a 46 vs 56-degree curve. If she hates her appearance now then you might consider surgery in the next 6-12 months. Bracing is not indicated for curves over 40 degrees especially in a young lady at 14 year old. Might consider if she was under 10 years just to buy time. No one has shown a brace to have any long term effect on curves over 40 degrees. So at this point, my recommendation would be to observe her curve over the next few years and if the curve gets into the mid 50’s degrees then surgery. If it holds steady and doesn’t change then hold off on surgery and follow her until her mid 20’s to make sure she’s stable and would not need surgery. If she’s not happy with how she looks then surgery may make sense - but it would be up to you and her whether to proceed with an operation. 

- Jay Shapiro, MD


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