The nature of scoliosis changes as the child grows. Your spine surgeon will start on treatment and will ask you to do regular checkups to monitor the effectiveness of the treatment. This is important to detect any increase in curve early so that the treatment plan can be changed appropriately.

Brace and exercise are common methods surgeons around the world use to control the curve. This is usually done in some case where the curve is still flexible and can be well controlled by brace, or in very your children where surgery is not desirable. There are numerous reports in medical science where the curve has been seen to be controlled by brace alone. Unfortunately, there is a lot of disagreement among spine surgeons regarding the effectiveness of brace.

One of the main problems a child faces is to wear the brace for 22 hours a day. Usually children of adolescent age don't co-operate with this as they feel self conscious.

Availability of good quality and low profile bracing plastics is also a problem in India. The braces are a little cumbersome and heavy and not tolerated well by children. It also needs careful repair to avoid pressure on the skin. The brace may also need to be changed in a growing child. This involves regular follow-up with the surgeon and the orthotist (the brace maker).

It is also necessary to regularly follow-up with the surgeon at advised intervals to find out whether the scoliosis is getting controlled with the brace. There may be instances where the surgeon feels that the curve is not getting controlled and advises surgical treatment.

Yoga has been increasingly used to control scoliosis in mild curves in association with brace wear. Unfortunately the results are not quite available in medical literature to suggest that it controls the curve. However, it does maintain the flexibility of the curve and the tone of the muscles, which is very beneficial.

Usually the curve is noticed just before the child attains puberty. The growth of the body reaches maximum speed at about the same time. This is the time when the curve increases in magnitude suddenly. In some mild cases, the parents notice the curve only after the sudden progression after puberty.

This depends on a lot of factors like curve severity, age of the child, chance of the curve becoming worse with growth etc. Usually a scoliotic curve progresses till maturity to about 18 years. After that, unless the curve is very large it does not usually progress. Consult your spine surgeon if you need to know how bad your child's curve is.

Around the world the most common procedure done for Idiopathic scoliosis is "Fusion Surgery". This involves opening the spine from the back with a long skin incision, putting metal screws in the back and connecting them with a rod. The rod is then turned to correct the bend and screws are tightened to hold it in place. Bone graft obtained from the patient is then spread on to allow gradual "fusion" or joining of one vertebra with another. The role of the implants is to hold the spine in corrected position till the bones join with one another.

It is a lengthy procedure that requires good planning and training on the part of the surgeon. Apart from the risks involved in all long surgeries and anaesthesia, there is a chance of spinal cord injury either at the time of screw insertion or when the spine straightens. This happens due to the sudden stretch. It happens in about 1 - 2 % of the cases and the recovery depends on the nature of the injury. It could result in paralysis or weakness of the limbs and loss of control of urine and bowels. This is something that every patient needs to understand before the procedure. The other problems involve infection and non fusion of bones both of which may require additional procedures.

The hump comes because of a bend in the ribs and is due to the deviated spine. When surgery is done some surgeons take out bit of ribs to remove the hump. Unfortunately no surgical procedure is a long term solution to the rib hump and usually there is some residual rib hump even after the surgery. However, other issues like uneven shoulders, hips and deviated head should have been solved to a great extent by the surgery.

Yes. Most people with corrected Idiopathic scoliosis lead a normal active family life. Contrary to popular belief, most females have no issues child bearing or delivery.

It is not necessary to do so. This involves extensive surgery and is not routinely advocated. Once the spine has fused, the metal implants are quite safe inside the body and need not be routinely removed.

This could be because of a variety of reasons. The most common is the disc problem.

Once majority of the spine is fused, that region doesn't move anymore and the mobile disc adjoining the fused area is over worked and commonly shows wear and tear. This is very similar to the common back pain seen in normal patients. The treatment depends on the severity of the wear and tear.

Even though it is not an emergency, it is important to time the surgery. Your surgeon will try to analyze the present curve severity and based on the medical evidence available and the growth left, will predict the severity at the completion of growth. If it is above a predetermined level, surgery will have to be done. It does not matter if there is a delay of a few months in most cases. However, in some cases, especially when the child is actively growing, the curve may increase suddenly requiring more extensive surgery. If the surgery is delayed well into the adulthood, the curve is not supple anymore and it requires extensive and complicated surgery to correct the curve which can well be avoided.