From the Guidelines
For a female teen with a thoracic spine lateral curvature of 10 degrees, observation and monitoring are recommended rather than immediate intervention. The patient should have regular follow-up appointments with a spine specialist every 6-12 months to track any progression of the curve, particularly during growth spurts. At this mild degree of curvature (less than 25 degrees), scoliosis-specific exercises focusing on core strengthening and posture improvement should be incorporated into the teen's routine, ideally under the guidance of a physical therapist familiar with scoliosis management 1. These exercises help maintain spinal flexibility and may prevent progression. The teen should maintain normal physical activity and sports participation as this curvature is not severe enough to warrant restrictions. Bracing is not typically recommended at this mild degree unless there are signs of rapid progression. This approach is justified because most mild scoliotic curves (under 25 degrees) do not progress significantly and rarely cause functional limitations or pain, as noted in the American College of Radiology guidelines 1. However, monitoring is essential during adolescent growth periods when the risk of progression is highest, particularly for female patients who tend to have higher progression rates than males. It's also important to exclude any underlying conditions that could be contributing to the scoliosis, such as neuromuscular disorders or vertebral anomalies, through a thorough clinical evaluation and radiographic assessment 1.
Some key points to consider in the management of this patient include:
- Regular follow-up appointments with a spine specialist to monitor curve progression
- Scoliosis-specific exercises to maintain spinal flexibility and prevent progression
- Maintenance of normal physical activity and sports participation
- Exclusion of underlying conditions that could be contributing to the scoliosis
- Consideration of bracing if there are signs of rapid progression.
Overall, the goal of management is to prevent progression of the curve and maintain the patient's quality of life, while minimizing the risk of complications and the need for surgical intervention 1.
From the Research
Treatment Options for Thoracic Spine Lateral Curvature
- For a female teen with a thoracic spine lateral curvature of 10 degrees, the treatment options are largely dependent on the severity of the curvature and the presence of any underlying conditions 2, 3, 4, 5, 6.
- According to the studies, mild scoliosis (Cobb angle of 10-25 degrees) is usually asymptomatic and may not require aggressive treatment 2, 3.
- However, it is essential to monitor the curvature to prevent progression, especially in females, who are at a higher risk of curve progression 2, 4, 5.
Conservative Treatment Approaches
- Physiotherapy Scoliosis Specific Exercises (PSSE) have been shown to be beneficial in limiting progression in mild to moderate scoliosis, improving back asymmetry, and reducing muscle imbalance and related pain 3.
- Bracing has been found to be an effective conservative treatment for adolescent idiopathic scoliosis (AIS), especially when combined with exercise-based physical therapy 6.
- Exercise-based physical therapy can prevent a worsening of the curve, decrease the need for bracing, and improve respiratory function 6.
Recommendations for Screening and Monitoring
- The American Academy of Orthopaedic Surgeons, the Scoliosis Research Society, the Pediatric Orthopaedic Society of North America, and the American Academy of Pediatrics recommend screening females twice, at age 10 and 12 years, and males once at age 13 or 14 years 4.
- Screening during routine well-child examinations and/or school-based evaluations can help identify patients who need ongoing monitoring 4.
- The evaluation of curvatures in conjunction with the level of skeletal maturity will help guide the management of the curvature 4.