From the Guidelines
Given the minimal degree of rotary scoliosis (less than 5 degrees) and the absence of any serious spinal issues, minimal follow-up is required, and a follow-up appointment with a primary care provider or orthopedic specialist in 6-12 months is recommended. The current findings are reassuring, with no evidence of compression injuries, spondylolysis, spondylolisthesis, or disc space narrowing 1. According to the American College of Radiology Appropriateness Criteria, radiography is the primary imaging modality used to classify scoliosis and monitor its progression, and MRI is utilized selectively to assess for neural axis abnormalities in high-risk patients 1.
For patients with mild scoliosis, such as in this case, the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) suggests limiting spine radiographs to once every 12 months for those at Risser stages 0 to 3 and every 18 months for patients at Risser stages 4 to 5, unless there are objective clinical changes in the appearance of the scoliosis 1. In the meantime, it is essential to focus on core-strengthening exercises, maintaining good posture, and staying physically active to support the spine. Over-the-counter pain medications like acetaminophen or ibuprofen can be used as needed for any discomfort.
Key points to consider in the management of this patient include:
- Monitoring the scoliosis periodically to ensure it doesn't progress, especially if experiencing back pain or discomfort
- Maintaining a healthy lifestyle, including regular exercise and good posture
- Using over-the-counter pain medications as needed for any discomfort
- Scheduling follow-up appointments with a primary care provider or orthopedic specialist as recommended.
From the Research
Follow-up for Slight Less Than 5-Degree Rotary Scoliosis
- The patient has been diagnosed with a slight less than 5-degree rotary scoliosis of the lumbar spine, with no evidence of compression injury, spondylolysis, or spondylolisthesis 2, 3, 4.
- The current treatment options for scoliosis include observation, physiotherapy scoliosis-specific exercises (PSSE), bracing, and surgery, depending on the severity of the curve and the patient's age 2, 4, 5.
- For a curve of less than 5 degrees, observation and PSSE may be recommended to stabilize the curve and improve posture 2, 5.
- PSSE has been shown to be effective in stabilizing and even reducing the Cobb angle of scoliosis, as well as improving quality of life indicators 2, 5, 6.
- The patient should be referred to a specialist, such as an orthopedic doctor or a physical therapist, to determine the best course of treatment and to develop a personalized exercise program 3, 4, 5.
- Regular follow-up appointments should be scheduled to monitor the curve and adjust the treatment plan as needed 2, 4, 5.