Diagnosis and treatment of spinal deformities. What to do for the patient with scoliosis.

Evaluation of scoliosis should include a careful medical history and a complete physical and neurologic assessment. Standing posteroanterior and lateral radiographs of the spine should be obtained and every effort made to arrive at an accurate diagnosis that pinpoints the cause of the spinal deformity. Special attention should be paid to painful spinal deformities in the pediatric population because they represent a potentially serious medical condition. Painful spinal deformities in adults usually respond to conservative therapy. Use of a spinal orthosis may help control pain in an adult and may prevent progression of a spinal deformity in a child or adolescent. Regardless of the patient's age, however, progressive or painful scoliosis may necessitate surgical treatment.