Some patterns of congenital scoliosis have a low potential for significant progression with growth, whereas others will progress aggressively at a very early age. Each pattern of malformation is unique and a treatment plan is made based on the risk of curve progression during growth. Treatment options in congenital scoliosis include observation, bracing, or surgery. The goals of treatment are to allow the child to reach the end of growth with a reasonably straight, balanced spine, and to allow the spine to grow as much as possible. For younger children, allowing for the chest cavity to grow and develop and allowing the lungs to increase in size is becoming increasingly recognized as an important consideration in the overall treatment plan.
Observation is appropriate for small curves and balanced patterns of malformations.
Some patterns of congenital scoliosis are minor enough that no treatment is needed and the long-term prognosis is good. Bracing is rarely used in congenital scoliosis as the primary treatment. Bracing has never been shown to profoundly change the pattern of abnormal growth that results from most vertebral malformations. It is sometimes useful to brace secondary curves that result from the congenital malformation. Surgery is used to attempt to maintain spinal balance while preserving as much trunk height as possible during growth.