ChiroACCESS Clinical Review

Adolescent Idiopathic Scoliosis: Therapy

This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Lead Author(s): 

Dwain M. Daniel, D.C.


How this evidence was rated:

Strength of Recommendation Taxonomy (SORT)

Published on

January 14, 2008

Text Size:     
A great disparity exists between allopathic medicine and chiropractic relating to the treatment of adolescent idiopathic scoliosis (AIS). Medical interventions often follow a "wait and see" philosophy where the goal of treatment is to prevent progression of the curve beyond a certain limit. When curves do progress significant time in the growth of the individual remains, the allopath can choose between two or three treatments, none which have been tested in randomized controlled trials. Chiropractic care is generally aggressively performed with the intention of reversing most curves, even minor curves. Similar to the allopath, very weak evidence demonstrates the efficacy of chiropractic care or the need to treat curves that have little statistical chance of progression to a significant level. Case studies represent the bulk of chiropractic research and are of limited value since up to 27.4% of curves show spontaneous improvement of at least 5° without treatment (1).

The following table has been modified from Reamy et al (2) and represents a common medical approach to treatment:

Cobb's angle

Risser grade



10 to 19 degrees

0 to 4

Every six months/ No


20 to 29 degrees

0 to 1

Every six months/Yes

Brace after 25°

20 to 29 degrees

2 to 4

Every six months/Yes


> 29 degrees

0 to 4


Brace or surgery**

* If patient is Risser grade 4 observation is warranted unless progression noted
** Surgery considered at 40°. If patient is Risser grade 4 surgery can be delayed unless progression is noted.

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