Question 1

Is there a difference between true scoliosis and scoliosis attitude?

Dr. Manoj Miglani · Accepted Answer

Yes. Scoliotic attitude is purely a postural thing, not a structural curve. A true structural curve is distinguished from a postural presentation using standing X-rays and bending views, which show whether the curve is rigid or fully correctable.

Question 2

As a traumatic scoliosis patient from DRC with a Cobb angle of 22 degrees, should I wear a custom-made corset or a removable corset with physiotherapy sessions?

Dr. Manoj Miglani · Accepted Answer

At a Cobb angle of 22 degrees, correction may not be needed at all. If there is no pain in the affected area of the spine, the curve is unlikely to progress further and has likely already stabilised, so no bracing or active intervention is required. X-ray pictures and clinical photos would be needed for a fuller review of the specific case.

Question 3

Can you say something regarding intraoperative monitoring during operative treatment of AIS?

Dr. Manoj Miglani · Accepted Answer

Intraoperative neuromonitoring is used routinely for curves more than 60-70 degrees, which makes the surgery much safer. The monitoring system stays active throughout the procedure, with checks after every screw placement and after every corrective manoeuvre, which is what keeps neurological complication rates under 1%, even for nerve root injury.

Question 4

When treating AIS with bracing: how many hours per day should a brace be worn, what are the indications for considering the treatment a failure, and when should surgical options be considered after failure of bracing as non-operative management?

Dr. Manoj Miglani · Accepted Answer

A brace should be worn for 22 hours a day to be effective. Treatment is considered a failure if the deformity progresses both clinically and radiologically despite bracing. Surgery should be considered once the child has more than 40 degrees of deformity with growth still remaining.

Question 5

What are the most common complications after surgical management of scoliosis, and how are they prevented?

Dr. Manoj Miglani · Accepted Answer

Routine complications similar to other major surgeries: bleeding, infection, paralytic ileus, and malposition of hardware. Specific rates are neurological injury under 1%, respiratory complications 2-8%, infection under 1%, and mesenteric artery issues around 2.7%, kept low through routine intraoperative neuromonitoring and surgical volume/experience at the centre.

Question 6

Is adolescent idiopathic scoliosis hereditary?

Dr. Manoj Miglani · Accepted Answer

Around 30% of adolescent idiopathic scoliosis cases have a family member with scoliosis, suggesting some hereditary or familial component, though it's far from universal. Congenital scoliosis and some neuromuscular or syndromic forms of scoliosis have a much stronger chance of being hereditary, since they involve clearer genetic transmission.

Question 7

For a patient being observed with a curve between 10 and 20 degrees, is it okay to start some physiotherapy or rehabilitation exercises, or does one have to wait?

Dr. Manoj Miglani · Accepted Answer

At 10 to 20 degrees, the focus should just be on exercises to keep the back muscles healthy and avoiding extremes of posture, that is all that is needed. Follow-up frequency with X-rays, whether every 3 months, 6 months or a year, depends on the child's age and Risser sign, not on whether they are doing exercises.

Question 8

You said between 3 to 6 months for the X-ray follow-up. Can you clarify how that's decided?

Dr. Manoj Miglani · Accepted Answer

If the child is young, say 10 years old with a 20-degree deformity, X-rays should be done every 3 months since they are likely to progress more. If the child is 13-14 years old with the same 20-degree curve, X-rays every 6 months to a year are enough, just to confirm the deformity isn't progressing rapidly.

Question 9

Is there any preventive treatment, such as exercises, bed positioning or diet, that can help avoid developing scoliosis or keep it from progressing?

Dr. Manoj Miglani · Accepted Answer

No, there are no preventive measures for idiopathic scoliosis, because the actual cause isn't known. The only genuinely useful advice is for the child to stay physically active, which most children naturally are.

Adolescent Idiopathic Scoliosis

Questions Doctors Asked Dr. Manoj Miglani