Dr. Lawing explains, “Treatment for scoliosis depends on the age and maturity of your child and the size of the curve. Most small curves that are less than 20 degrees won’t progress and can be observed. For the curves that do progress to the low to mid-20s, we use braces (thoracic lumbar sacral orthoses or TLSO) to keep it from getting worse. Braces cannot correct scoliosis, but can be highly effective in preventing progression, or worsening, of your child’s curve. Because braces do not correct scoliosis, but only keep it from getting worse, close monitoring is necessary for borderline curves to allow for early initiation of the brace once the curve needs treatment.” Braces work by helping to more evenly distribute the forces across the growth plates of your child’s spine. Dr. Lawing says, “Once your child is done growing, there is no further role for bracing. There are two main types of braces. A full-time brace is worn with a goal of 18 – 23 hours a day until your child is done growing. “ Nighttime bending braces are worn only at night and work by bending your child’s spine into a more exaggerated corrected position. Medical studies suggest that the full-time braces are more powerful and we typically use them in higher-risk curves. Once a curve reaches a certain size, 50 degrees for thoracic curves, surgery is recommended to keep it from getting worse throughout your child’s life. Dr. Lawing explains, “Surgery takes the form of posterior spinal fusion, which uses rods and screws to pull the spine as straight as possible and help it heal in this better position. While your child won’t be able to do sports for about six months, most children are able to resume their normal activities starting at six months after surgery.” Although this is a big surgery, we have a number of tools we use to make it very safe. Children typically spend three days in the hospital after the surgery. “For babies with scoliosis,” continues Dr. Lawing, “the curve can progress so rapidly that there is potential for their heart and lungs to be impacted. Mehta casting is a non-invasive tool that can be used to stop progression. In around 50% of children, the scoliosis is cured. This involves a series of casts that are placed under general anesthesia, but doesn’t involve surgery or incisions on your child’s back.” The casting works by harnessing the remarkably rapid growth of the first five years of life and is more effective the earlier it’s started.