From the Guidelines
A mild degree of scoliosis, typically less than 10 degrees, is considered normal or physiologically insignificant. This is based on the definition of scoliosis as a lateral curvature of more than 10 degrees on a standing posteroanterior (PA) radiograph, as stated in the study by 1. Most people have some slight curvature in their spine, and curves under 10 degrees are generally not classified as clinical scoliosis. These minor curves don't require treatment or monitoring as they don't cause symptoms or progress over time.
Key Points to Consider
- Healthcare providers typically only begin monitoring when curves reach 10-25 degrees, which is classified as mild scoliosis.
- Treatment interventions like bracing are usually only considered when curves reach 25-40 degrees, while surgical options may be discussed for curves exceeding 40-50 degrees.
- The reason small curves are considered normal is that perfect spinal alignment is rare in humans due to natural asymmetries in muscle development, posture habits, and minor developmental variations.
- These minimal curves don't impact function or health and represent normal human anatomical variation rather than a medical condition requiring intervention, as supported by the study 1.
Clinical Implications
- It is essential to distinguish between physiological and pathological scoliosis to avoid unnecessary treatment and monitoring.
- A thorough clinical evaluation, including radiographs and physical examination, is necessary to determine the degree and type of scoliosis.
- The study by 1 highlights the importance of excluding underlying structural abnormalities or accompanying syndromes in the diagnosis of idiopathic scoliosis.
From the Research
Definition of Normal Scoliosis
- The degree of scoliosis that is considered normal is not strictly defined, but it is generally accepted that a Cobb angle of less than 10° is considered mild and may not require treatment 2, 3.
- A Cobb angle between 10° and 20° is considered moderate, and treatment may be recommended to prevent progression of the curve 3, 4.
- A Cobb angle greater than 20° is considered significant, and treatment is often necessary to prevent further progression and potential complications 2, 5, 6, 4.
Factors Influencing Scoliosis Severity
- The severity of scoliosis can be influenced by various factors, including age, skeletal maturity, and curve magnitude 6.
- Studies have shown that scoliosis-specific exercises, such as the Schroth exercise, can be effective in reducing Cobb angle and improving quality of life, especially for patients with mild to moderate scoliosis 3, 4.
- However, the effectiveness of these exercises can vary depending on individual factors, such as age, skeletal maturity, and exercise compliance 6.
Treatment Options
- Treatment options for scoliosis depend on the severity of the curve and the individual's overall health 2, 5.
- For mild scoliosis, observation and monitoring may be sufficient, while moderate to severe scoliosis may require bracing, physical therapy, or surgery 2, 3, 5, 6, 4.
- In severe cases, respiratory failure can occur, and treatment may need to be tailored to address these complications 2.