Scoliosis (curvature of the spine) is managed based on the type and severity of curve. A smaller curve (mild scoliosis) can be treated conservatively without surgery. A larger curve (moderate to severe scoliosis) often requires fusion to straighten it as much as possible and keep it from getting worse.
X-rays are used to determine the degree of the main curve. An angle called the Cobb angle is measured and used as a guide to conservative versus surgical treatment. Newer studies have been done using three-dimensional systems to map out the shape of the spine. There is some thinking that not just the size of the curve but also the pattern of curvature must be considered when planning treatment.
This alternative approach zeroes in on the location and amount of rotation of the vertebral bodies. Looking at whether the curve is single, double, to the right, or to the left can be augmented by seeing if it rotates clockwise or counterclockwise. Stereoradiographic X-rays show these patterns by taking pictures from above the patient.
Up until now, the main way to view treatment was based on size of the curve (small versus large). Small curves can be treated conservatively with bracing when needed. Large curves are more likely to require surgery. Although rotation of the curve can’t be used as the only guiding factor, size shouldn’t be the only determining point either.
Treatment or management decisions for all patients with scoliosis are made on a case-by-case basis. There’s no reason not to seek a second opinion. Put together a list of questions about how they make their treatment decisions. Compare it to the first facilities policies and see how they are similar or differ. If both teams make the same recommendation, you may feel better about taking a more aggressive approach than you would otherwise be comfortable with.