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Navigating Scoliosis Treatment: From Braces to Surgery and Beyond

Introduction

When you think of scoliosis, what comes to mind? Perhaps a childhood diagnosis or a visibly curved spine. Scoliosis, however, encompasses more than a spinal curvature; it can significantly impact daily life in ways that are often overlooked.

Scoliosis is a medical condition characterized by an abnormal lateral curvature of the spine, often forming an “S” or “C” shape. While the spine typically appears straight when viewed from behind, individuals with scoliosis exhibit a sideways curve that can vary in severity. This condition is most commonly diagnosed in children and adolescents, particularly during growth spurts, but it can affect individuals at any age, including adults.

The impact of scoliosis on daily life ranges from minimal to significant, depending on the degree of curvature and individual circumstances. Those with little curvature may have mild or no pain, while more severe curvatures can lead to chronic back pain, reduced mobility, and visible postural changes such as uneven shoulders or hips. In some instances, severe scoliosis can also affect lung and heart function due to the distortion of the chest cavity.

In children and adolescents, it may lead to noticeable physical changes, while adults might experience chronic pain and functional limitations. Recognizing scoliosis as a progressive condition underscores the importance of early diagnosis and proactive management.

Understanding Scoliosis Progression

The severity of scoliosis is measured using something called the Cobb angle. This number shows how much the spine curves, based on an X-ray. A higher Cobb angle means a more noticeable curve, which helps doctors decide the best treatment approach — whether it’s watching the curve over time, using a brace, or considering surgery.

For many children and teens with moderate scoliosis (typically curves between 25–45 degrees), bracing is the first treatment considered—especially if the spine is still growing.

How Braces Work

Braces don’t reverse scoliosis, but they can prevent the curve from getting worse. By applying consistent external pressure, they guide the spine’s growth and help delay or avoid surgery. There are several brace designs tailored to individual needs, including:

  • TLSO (Thoraco-Lumbo-Sacral Orthosis) – one of the most common.
  • Boston brace – widely used and customizable.
  • Rigo-Cheneau brace – designed for three-dimensional correction.
  • Providence/nighttime brace – worn only at night for certain curve types.

Bracing typically requires daily wear for up to 18–23 hours, depending on the treatment plan. While some physical activities may be restricted, many kids continue sports and daily routines. Bracing usually ends once skeletal growth stops. Studies show that bracing can be effective in slowing or halting curve progression in many cases. However, it does have limitations—it requires consistent use and doesn’t work equally for everyone.

Surgical Options for Scoliosis

Surgery is generally recommended when the curve is greater than 50 degrees, if there’s rapid progression, or if bracing has failed to stop worsening the curve. Common surgical procedures include the following:

  • Spinal Fusion: This is the most common scoliosis surgery. It involves fusing two or more vertebrae together using rods, screws, and bone grafts to stabilize the spine and prevent further curvature. Recovery can take several months but typically results in significant improvement.
  • Growing Rods & Vertebral Body Tethering (VBT): These are used for younger patients whose spines are still growing. Growing rods are periodically lengthened to keep up with the child’s growth, while VBT uses a flexible cord to guide the spine’s growth without fusion.
  • Minimally Invasive and Fusionless Procedures: Emerging options are being developed, offering smaller incisions, faster recovery, and the possibility of preserving more spinal flexibility.

While surgery often leads to lasting improvement in spinal alignment and quality of life, it carries risks like infection, hardware issues, and nerve damage. A thorough discussion with your surgeon is critical to understanding your specific risks and expected outcomes.

Beyond Braces and Surgery: Additional and Supportive Treatments

Scoliosis care doesn’t end with braces or surgery — many patients find relief and support through complementary treatments such as physical therapy to improve posture and reduce pain, pain management strategies like medications or bracing (especially for adults), and lifestyle adjustments including low-impact exercise, stretching, or mindful movement like yoga or Pilates. Some also explore alternative therapies like chiropractic care or acupuncture, which may offer symptom relief when used responsibly alongside medical treatment, though evidence for their effectiveness is limited.

Living with Scoliosis: What Patients Should Know

Scoliosis is a lifelong condition, but with regular check-ups, a strong support system, and care for both body and mind, many people—especially teens—can stay active, build confidence, and enjoy a full and rewarding life.

Conclusion

There is no one-size-fits-all treatment for scoliosis. Every spine is different—and so is every patient. It is key to have individualized care that takes into account your needs, goals, and stage of life. From bracing to surgery and supportive therapies, understanding available treatment can empower you to evaluate options and choose the best one for you. If you or a loved one has been diagnosed with scoliosis, don’t wait. Early evaluation leads to better outcomes.

To learn more or find care; schedule an appointment online or call 608.234.7436.

 

Former pro sports doctor joins Southeast Orthopedic Specialists to treat residents in Northeast Florida

Dr. David Doward to help deliver spine and sports medicine care

JACKSONVILLE, June 9, 2025 – Southeast Orthopedic Specialists (SOS) is excited to welcome Dr. David Doward to its expanding team of musculoskeletal (MSK) experts. Dr. David Doward is a board-certified physician in Physical Medicine and Rehabilitation, and fellowship trained in Interventional Spine and Sports Medicine. Dr. Doward specializes in comprehensive pain management treatments and is recognized for his patient-centered, non-surgical approach to musculoskeletal (MSK) care, helping individuals regain mobility and get back to activities they love.

Dr. Doward earned his medical degree from Weill Cornell Medical College following undergraduate and premedical studies at Lafayette College and Columbia University. He completed his residency in Physical Medicine and Rehabilitation at Stanford University Hospitals & Clinics and pursued advanced fellowship training in Interventional Spine and Sports Medicine at the prestigious Hospital for Special Surgery.

Throughout his career, Dr. Doward has authored nine peer-reviewed publications, contributed to six research studies, and served as a team physician for the Jacksonville Jaguars and Jacksonville Sharks. He has also provided medical coverage for elite international tennis events, including the Davis Cup and Fed Cup.

Known for his thoughtful clinical insight, hands-on care, and collaborative treatment planning, Dr. Doward partners closely with patients and referring providers to craft individualized care plans that align with each patient’s goals and lifestyle.

“We are so excited to have Dr. Doward on our team and look forward to the positive impact his care and expertise will bring to our patients and the Northeast Florida community,” said Donnie Romine, CEO of Southeast Orthopedic Specialists. “His impressive academic background, experience treating elite athletes, and dedication to delivering personalized, high-quality care makes him an exceptional addition to the SOS family as we continue to expand access to exceptional orthopedic and spine care in the region.”

Outside of medicine, Dr. Doward enjoys traveling, playing tennis, and spending quality time with his family.

With the addition of Dr. Doward, Southeast Orthopedic Specialists continues to strengthen its mission of delivering comprehensive, patient-centered musculoskeletal care to communities across Northeast Florida. At SOS, patients can count on a seamless experience — from initial evaluation and non-surgical treatment to surgery and recovery — all managed by a trusted team under one roof.

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About Southeast Orthopedic Specialists 

Established in 2001, Southeast Orthopedic Specialists has grown into the regional leader in musculoskeletal care. Southeast Orthopedic Specialists was founded on the principle of providing high-quality, comprehensive care in the Northeast Florida region. The entire spectrum of musculoskeletal healthcare services is provided to patients including orthopedic surgery, spine care, physical medicine and rehabilitation, pain management, chiropractic and podiatry. Services including physical therapy, regenerative medicine, advanced imaging, durable medical equipment and musculoskeletal urgent care are offered in multiple locations throughout the region. Physicians at Southeast Orthopedic Specialists are leading experts in their field with decades of experience, including the completion of multiple fellowships and groundbreaking research. Visit www.se-ortho.com to learn more.

 

About Healthcare Outcomes Performance Company (HOPCo)  

Healthcare Outcomes Performance Company (HOPCo) is the national leader of integrated musculoskeletal value-based health outcomes management, practice management and health system service line management. This includes comprehensive expertise across all MSK specialties, including orthopedics, spine, neurosurgery, hand, pain management, rehabilitation and neurology. HOPCo’s integrated care, analytics and facilities development and management platforms have proven to increase the quality of patient care while reliably reducing the total cost of care across the care continuum for practices, health systems and payors alike. HOPCo’s affiliated payors, practices and health systems successfully participate in highly efficient value-based contracting (bundled payments, chronic episodes of care initiatives, population health programs and other advanced risk-based arrangements) utilizing HOPCo’s proprietary platforms, IT solutions, integrated analytics and evidence-based comprehensive care pathways. Visit https://hopco.com to learn more.

 

Media Contact:

Annebeth Ahrenholz

Communications Specialist

Healthcare Outcomes Performance Company (HOPCo)

Annebeth.Ahrenholz@hopco.com

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