ENGerman scoliosis treatment revolves around two questions: how large the curve is and how much growth the child has left. Families usually arrive with a similar story: one shoulder sits higher or a shoulder blade sticks out, the doctor at home advised waiting, and nobody could say how long waiting is safe.
Adults have scoliosis too, carried over from childhood or developing with age. Below we cover the forms, diagnosis, non-surgical treatment, surgery, centres and how AlenMed arranges the trip.
What scoliosis is and why forms are treated differently
Scoliosis is a sideways curve of the spine in which the vertebrae also rotate, which changes the shape of the rib cage and can create a rib hump. Its forms are treated differently because their causes differ. The most common is adolescent idiopathic scoliosis: it appears in healthy children during rapid growth, and its cause is unknown. Congenital scoliosis stems from malformed vertebrae, while neuromuscular scoliosis accompanies nerve and muscle diseases such as cerebral palsy.
In adults, scoliosis causes back pain and fatigue, sometimes with pressure on nerves that sends pain into a leg. The aim is therefore to ease pain and keep the spine mobile rather than to stop a growing curve. Children’s orthopaedic surgeons treat far more than scoliosis, as the page on paediatric orthopaedics in Germany shows.
Diagnosis: angle, growth and progression
Treatment depends on the angle of the curve, the growth still ahead and how fast the curve changes. The doctor examines the back as the child bends forward, then a standing X-ray of the whole spine shows the Cobb angle, measured between lines along the most tilted vertebrae at each end of the curve. According to the guidelines of the international scoliosis society SOSORT, scoliosis is not diagnosed below 10 degrees. A curve above 30 degrees at the end of growth raises the risk that it will keep progressing in adulthood, and above 50 degrees this is almost certain. Remaining growth is judged from bone X-rays, for example of the pelvis.
MRI is used for congenital forms, pain, unusual curves or neurological signs. In adults, nerve tests are added, and marked deformity calls for a lung function check. Older X-rays matter too: they show how fast the angle has changed.
Non-surgical treatment: monitoring, bracing, exercise
Non-surgical treatment means monitoring, bracing or scoliosis-specific exercise, chosen by the angle and the growth remaining. Small curves in a growing child are monitored with regular check-ups and X-rays.
If the curve progresses, a corrective brace is prescribed; the Chêneau type is widely used in Germany. It is custom-made from a cast or body scan and presses on the apex of the curve, not to straighten the spine but to stop the curve increasing during growth. A brace only works while it is worn, so the hours matter: full-time bracing, as SOSORT defines it, means 20–24 hours a day. In the BrAIST trial, bracing was less likely than observation to let curves progress to the threshold for surgery, and the benefit grew with longer hours of wear.
Scoliosis-specific exercise, such as the Schroth method, matches breathing and exercises to the individual curve so that the patient learns to straighten the trunk. Adults receive pain therapy, physiotherapy and back-muscle training.
Scoliosis surgery in Germany
Scoliosis surgery in Germany is discussed when a curve is large or progressing fast, bracing has failed, or an adult’s pain and nerve compression do not respond to conservative care. The standard operation is spinal fusion: the spine is straightened and held with rods and screws, and the vertebrae in that segment grow together.
Young children receive growing rods instead, lengthened as they grow. During surgery, neuromonitoring checks spinal cord function, and rehabilitation follows. Other operations are covered on the spine surgery page, costs on the spine treatment prices page.
Centres treating scoliosis
Scoliosis is treated in specialised spine centres. The Werner Wicker Klinik in Bad Wildungen runs a spine centre and the German Scoliosis Centre (Deutsches Skoliosezentrum) and has treated scoliosis patients since 1978; the chief physician is Dr Luis Ferraris, who focuses on spine surgery and scoliosis. Asklepios Orthopaedic Hospital Bad Abbach has a centre for spine and scoliosis therapy (Orthopaedics II) with its own children’s spine and scoliosis centre.
At University Hospital Leipzig, Prof. Christoph-Eckhard Heyde heads the children’s spine centre and spine surgery. His fields include complex spinal deformities in children and spinal disease at all ages.
Frequently asked questions
Can scoliosis be treated without surgery?
Often, yes: small curves in children are monitored, and progressing curves are treated with a brace and scoliosis-specific exercise. A brace does not straighten the spine; it holds the angle during growth. If the curve still becomes large, or an adult’s pain and nerve compression persist, the surgeon will discuss an operation.
How many hours a day must a brace be worn?
As many as the doctor prescribes, usually most of the day; full-time bracing means 20–24 hours. The brace is worn until the spine stops growing and then weaned off gradually, guided by X-rays. If it rubs, see the orthotist rather than leaving it off.
Can adults with scoliosis be treated?
Yes, but the goal is to ease pain, keep the spine mobile and relieve pressure on nerves. Conservative care usually comes first: physiotherapy, back-muscle exercises and pain therapy. Surgery is discussed if pain, numbness or leg weakness persist and the deformity progresses, after the surgeon has reviewed X-rays, MRI scans, bone strength and general health.
What should we bring to a consultation at a scoliosis centre?
Bring every X-ray of the spine, recent and old, ideally digital and with reports, so the doctor can see how the angle has changed. MRI scans, specialist reports and records of the child’s growth also help. If the child already wears a brace, bring it so the doctor can check the fit.
How AlenMed arranges scoliosis treatment
AlenMed starts before the trip: we translate reports and records into German and send them with the images to a scoliosis centre, whose doctor gives a preliminary opinion on monitoring, bracing or a surgical consultation.
For a family with a child, we book the appointment, request a cost estimate, prepare the visa invitation letter and find accommodation near the hospital. An interpreter attends consultations and brace fittings. AlenMed’s office is in Munich, and partner hospitals are all over Germany.
After you return home, we schedule follow-up visits and keep you in touch with the doctor.
This material is for information only and is not an offer. The treatment plan is decided by a doctor at an in-person consultation.