Question from young adult who was braced as an adolescent with Boston TLSO: should she see orthopaedic surgeon as an adult?

Today I received this message from a young lady named Iris via my Blog:

Hi Dr. Hey!I found your blog when I was searching for blogs that mentioned scoliosis. It’s neat how you are blogging about your patients and the treatment they are getting. I have scoliosis and wore a Boston TLSO for over a year. I was treated at Shriner’s Hospital. My curve was 38 degrees at my last appointment. I currently do not have any major problems, but I wonder if I should go see an orthopedic surgeon sometime in the future to see if it is progressing at all. Perhaps I will, if I develop any problems.I will be continuing to read your blog!- Iris

Answer from Dr. Hey:
Iris, this is an excellent question.
Yes, it is important to be followed by a clinic comfortable taking care of adults with scoliosis.
As a young adult, you should probably have your scoliosis checked once a year through age 30 or so, and then every 2-3 years thereafter.
You should especially be sure to get your scoliosis checked before and after each pregnancy, since pregnancy may increase the curve dramatically, due to the ligamentous laxity caused by hormonal changes, and also the weight of pregnancy.

Sometimes a scoliosis curve can be stable over even many years, but then start collapsing during later years in 40’s or 50’s when degeneration causes especially the lower curve to destabilize.
It’s much better if possible to fix a progressive scoliosis during your early years since the curves are smaller and much more flexible, and the lower curve degeneration can hopefully be prevented due to the mis-aligned loading of the lower spine.

It is important for parents and adolescents with scoliosis to know that bracing can help slow down curve progression during adolescence, but it does not guarantee that the curve will not progress during adulthood, even if the curve when you finish growing is less than 50 degrees.  Meredith, who works in my office at Hey Clinic had a 30 degree curve when she was done growing, but the curve went to 45 degrees when she was a senior in college, at which point she had it fixed.  Many others have had similar experiences, and are often angry if they were not told about the potential for progression after they were “done growing.”

It is very important for you to have accurate scoliosis measurements made with proper scoliosis X-Rays, preferably by the same physician or physician’s assistant to decrease measurement error.
Keep copies, preferably digitally of all of your X-rays, since each of these data points, even a decade later may be important for verifying curve progression.
Curves during adulthood often only progress at a degree per year, so it often takes a few years to confirm the progression.
Scoliosis and Kyphosis are life-long conditions, and require life-long follow-up.

Take care, and I am glad you enjoy the Blog!!

Please send along other questions if you would like.

Sincerely,

Dr. Lloyd Hey
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery

One Comment
  1. Reply
    Journey_On

    Dr. Hey,
    Thank you so much for your feedback – that was a very pleasant surprise!!

    I wanted to add some more details about my situation: I was diagnosed at age 13 with a curve of 32 degrees (menarche had already occurred by this time). When I was first diagnosed, I started wearing the Charleston bending brace at night time. Four months later, my curve progressed to 38 degrees. This is when I started going to Shriners Hospital and started wearing the Boston TLSO for about 23 hours a day. Overall, I was very good at wearing the brace, and the brace successfully kept the curve from progressing.

    My last appointment was when I was 18 with the same degree of curvature. I am 23 now and have not been to an orthopedic doctor since that last appointment. Everything seems to be stable both physically and visually, but the only way to really tell would be to see a doctor. Thankfully, scoliosis does not affect my daily life, but the uneven shoulder blades bother me when I am sitting in a hard chair. I am currently finishing up my first semester of nursing school and am enjoying it. =) I hope that when I start my new career, my scoliosis won’t be too much of a problem. I am slightly concerned, as I have heard from many nurses that they have bad backs, and I wonder if the duties of nursing would affect my scoliosis at all.

    Thank you again for your very informative post!

    – Iris

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