An algorithm for the management of scoliosis

Scoliosis is a lateral and rotary deformity of the spine that is often found in children. Treatment of this deformity is based on the principle of early recognition and prevention, although surgical correction may be warranted in the case of progressive curves. There is no scientific evidence that spinal manipulative therapy (SMT) has any effect on curve progression in patients with idiopathic scoliosis; however, there is clinical evidence that SMT is a useful treatment for those patients who have an associated mechanical backache. This paper reviews the classification, natural history, pathogenesis, and clinical and radiological assessment of scoliosis. An algorithm for the management of scoliosis by chiropractors is presented, and illustrative cases from a scoliosis clinic in a university hospital are used to reinforce important clinical principles.