From the Guidelines
Levoscoliosis treatment should be individualized based on the severity of the curve, the patient's age, and whether the condition is causing pain or affecting function, with a focus on minimizing morbidity, mortality, and improving quality of life. The treatment options for levoscoliosis, a left-sided curvature of the spine, can be categorized based on the severity of the curve. For mild cases (curves less than 25 degrees), observation with regular X-rays every 4-6 months during growth periods is often sufficient 1. For moderate curves (25-45 degrees) in growing children, bracing is the primary treatment, typically using a thoracolumbosacral orthosis (TLSO) brace worn 16-23 hours daily until skeletal maturity 1.
Treatment Options
- Observation for mild cases
- Bracing for moderate cases
- Surgical intervention for severe cases
- Physical therapy for symptom management
- Pain management with non-steroidal anti-inflammatory drugs
For severe curves (over 45-50 degrees) or those causing significant pain or functional limitations, surgical intervention may be necessary, typically involving spinal fusion with instrumentation to correct and stabilize the curve 1. It is also important to note that levoscoliosis is sometimes associated with underlying conditions, so addressing any underlying causes is crucial for comprehensive treatment. Pain management for symptomatic cases may include non-steroidal anti-inflammatory drugs like ibuprofen (400-800mg every 6-8 hours) or naproxen (250-500mg twice daily) 1.
Key Considerations
- Severity of the curve
- Patient's age
- Presence of pain or functional limitations
- Underlying conditions
- Regular monitoring with X-rays to detect curve progression
From the Research
Treatment Options for Levoscoliosis
The treatment options for levoscoliosis, a type of scoliosis with a left-sided curvature, depend on various factors such as the severity of the curvature, age, and skeletal maturity of the patient.
- Observation: For mild curves, observation is recommended, with regular check-ups to monitor the progression of the curve 2, 3.
- Orthotic Management: For curves between 20-40 degrees, orthotic management, such as bracing, may be recommended to prevent further progression 2, 3.
- Surgical Correction: For curves greater than 40-50 degrees, surgical correction with fusion may be necessary to stabilize the spine and prevent further progression of the curve 2, 4, 5.
- Transcutaneous Electrical Muscle Stimulation: This treatment has been used to treat spinal curvature, with a success rate of 93% in preventing further progression for curves below 30 degrees 6.
- Decompression, Correction, Stabilization, and Fusion Procedures: These surgical procedures may be used to treat adult scoliosis, with the goal of relieving symptoms and improving quality of life 4.
Factors Influencing Treatment
The treatment of levoscoliosis is influenced by various factors, including:
- Age and Skeletal Maturity: The treatment approach varies depending on the patient's age and skeletal maturity 2, 3, 5.
- Curve Magnitude: The severity of the curvature is a key factor in determining the treatment approach 2, 4, 3.
- Presence of Underlying Conditions: The presence of underlying conditions, such as congenital or developmental osseous or neurologic abnormalities, may influence the treatment approach 4, 3.