Clinical Insights on Scoliosis and Its Treatment Options

Overview of Scoliosis and Its Types

Scoliosis is a three-dimensional deformity of the spine characterized by lateral curvature and vertebral rotation, often measured using the Cobb angle. It is classified into various types, with idiopathic scoliosis (IS) being the most prevalent form, accounting for approximately 80% of cases. Other types include congenital scoliosis, which arises from vertebral anomalies, and neuromuscular scoliosis, often associated with conditions such as cerebral palsy and muscular dystrophy.

Scoliosis can manifest during different life stages, but adolescent idiopathic scoliosis typically becomes evident during growth spurts. The condition can lead to complications, including pulmonary function impairment, back pain, and psychosocial issues due to physical appearance (Weiss et al., 2016).

Table 1: Classification of Scoliosis Types

Impact of Scoliosis on Pulmonary Function

The relationship between scoliosis and pulmonary function has been extensively studied, particularly in patients with severe curvatures. The thoracic cavity’s shape and volume can be adversely affected by spinal deformities, leading to compromised lung capacity and ventilation mechanics. A systematic review found that patients with scoliosis often exhibit decreased Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1), especially when the Cobb angle exceeds 50 degrees (Oliveira et al., 2025).

Table 2: Pulmonary Function Parameters in Scoliosis Patients

Long-term follow-ups indicate that surgical interventions, such as spinal fusion, may help improve pulmonary function parameters, although the extent of improvement can vary based on the severity of the curve and the age at which surgery is performed. Interestingly, studies suggest that while surgical options can stabilize or improve scoliosis, the relationship between correction and pulmonary function is complex and multifactorial (Te Hennepe et al., 2025).

Surgical Interventions for Scoliosis: Techniques and Outcomes

Surgical treatment for scoliosis is generally reserved for moderate to severe cases where conservative management fails. The primary goal of surgery is to reduce curvature, stabilize the spine, and prevent progression.

Techniques include:

1. Posterior Spinal Fusion (PSF): Involves fusing the affected spinal segments through posterior access, typically using screws and rods for stabilization.
2. Anterior Spinal Fusion (ASF): Can be performed through thoracotomy or laparoscopically, allowing for direct access to the intervertebral disc spaces.
3. Combined Approaches: Utilizes both anterior and posterior techniques to achieve maximum correction and stability.

A comparative analysis over a decade indicated that patients undergoing PSF exhibited significant improvements in Cobb angles with a low complication rate, emphasizing the technique’s effectiveness (Zhang et al., 2025).

Table 3: Surgical Outcomes in Scoliosis Patients

Non-Surgical Treatment Approaches: Efficacy of Schroth Therapy

Schroth therapy is a nonsurgical approach designed to manage scoliosis through specific exercises that focus on muscle strengthening, postural correction, and respiratory training. Recent studies have shown that patients who engage in Schroth therapy experience significant improvements in their Cobb angles and overall quality of life (Schreiber et al., 2016).

The efficacy of this method has been demonstrated through a systematic review indicating that Schroth therapy can lead to a reduction in the Cobb angle by an average of 6.8° after a treatment duration of 11 months (Ayvaz et al., 2025).

Table 4: Outcomes of Schroth Therapy

Neurological Complications Following Spinal Surgery for Scoliosis

Neurological complications are a concern in spinal surgeries for scoliosis, with rates of injuries varying based on the surgical technique and patient demographics. A systematic review indicated that the incidence of neurological complications following Anterior Lumbar Interbody Fusion (ALIF) ranges from 4.1% to 7.7%, with higher risks observed in cases involving L5-S1 levels and patients with spinal deformities (Fujii et al., 2025).

Table 5: Neurological Complications Post-Surgery

Surgical planning must consider these risks, particularly in patients with pre-existing conditions that predispose them to nerve injuries. Strategies to minimize such complications include meticulous surgical technique, preoperative imaging, and intraoperative neuromonitoring.

FAQs

What is scoliosis?

Scoliosis is a spinal deformity characterized by an abnormal lateral curvature of the spine, which can lead to complications such as pain and respiratory issues.

What are the types of scoliosis?

There are several types of scoliosis, including idiopathic, congenital, neuromuscular, and degenerative scoliosis.

How does scoliosis affect pulmonary function?

Scoliosis can compromise pulmonary function by altering the shape and volume of the thoracic cavity, leading to reduced lung capacity and ventilation efficiency.

What are the treatment options for scoliosis?

Treatment options range from observation and bracing for mild cases to surgical interventions such as spinal fusion for more severe curvatures.

What is Schroth therapy?

Schroth therapy is a specialized exercise regimen designed to improve spinal alignment, strengthen muscles, and enhance respiratory function in individuals with scoliosis.

What are the risks associated with spinal surgery for scoliosis?

Risks include infection, neurological complications, and the potential for reoperation, particularly in surgeries performed at the L5-S1 level.

References

1. Ayvaz, E., Uca, M., & Ayvaz, E. (2025). Clinical and economic effectiveness of Schroth therapy in adolescent idiopathic scoliosis: insights from a machine learning- and active learning-based real-world study. https://doi.org/10.1186/s13018-025-05900-2

2. Fujii, T., Kumar, R., Cha, J., & Bansal, A. (2025). Neurological complications following anterior lumbar interbody fusion (ALIF): a systematic review

3. Oliveira, J. A. A., Visconti, R. D., & Pedrosa Araújo, A. E. J. (2025). IMPACT ON PULMONARY FUNCTION AFTER SPINAL FUSION IN CONGENITAL SCOLIOSIS. https://doi.org/10.1590/1413-785220253302e284920

4. Schreiber, S., Parent, E. C., Hill, D. L., Hedden, D. M., Moreau, M. J., & Southon, S. C. (2016). Patients with adolescent idiopathic scoliosis perceive positive improvements regardless of change in the Cobb angle: results from a randomized controlled trial comparing a 6-month Schroth intervention added to standard care and standard care alone. https://doi.org/10.1186/s12891-019-2695-9

5. Te Hennepe, N., Steegh, V. L. J. M., Pouw, M. H., Roukema, J., De Kleuver, M., & Van Hooff, M. L. (2025). Pulmonary function in patients with adolescent idiopathic scoliosis: an explorative study of a wearable smart shirt as a measurement instrument. https://doi.org/10.1007/s43390-024-00938-4

6. Zhang, H., Du, Y., & Wang, S. (2025). Two-level versus multi-level fusion in posterior hemivertebra resection for congenital early-onset scoliosis: a 10-year comparative analysis of clinical outcomes and complication rates. https://doi.org/10.1186/s13018-025-05971-1