Named for convexity. Prominent hump on the right = dextroscoliosis
Etiology - idiopathic, may be a genetic component
= Cobb angle 5-15, Treat with OMT & Konstancin exercises
- Moderate = Cobb angle 20-45, Treat with spinal orthotic bracing (goal is to prevent further progression of the curve, not correct pre-existing curvature)
- - Boston brace: thoraco-lumbo-sacral-orthotic, used for curves in the lumbar or thoraco-lumbar spine
- - Charleston bending brace: indicated for spinal curves of 20-35 with the apex of the curve below the shoulder blade; bends the patient toward the convexity of their curve overnight
- - Providence brace: used for lower thoracic or thoraco-lumbar curves, worn at night
- - Wilmington brace: used for lumbar or thoraco-lumbar curves, made from light weight plastic and designed as a "body jacket"
- - Milwaukee brace: cervico-thoraco-lumbo-sacral-orthosis, indicated to treat high thoracic curves.
= Cobb angle >50, Treat with surgery (Harrington rod placement, Cotrel-Dubousset system, Texas Scottish Rite Hospital system, Zielke system)
Risk factors for scoliotic curve progression = female gender, primarily thoracic curves, larger initial curve magnitude, skeletal immaturity (Risser sign)