What is the recommended treatment for scoliosis with a Cobb angle greater than 50 degrees?

In cases where scoliosis presents with a Cobb angle greater than 50 degrees, surgical intervention is generally recommended. This is primarily due to the associated risks of progression of the curvature, which can lead to significant cosmetic and functional issues, as well as potential respiratory compromise. Scoliosis with such a pronounced angle is considered severe, and surgical correction can aid in stabilizing the spine and improving the patient's overall quality of life.

Surgical options typically include spinal fusion, which helps to correct the curvature and prevent further deterioration. This approach is chosen to manage the condition effectively and to address any associated complications that may arise from the curvature, especially in adolescents or young adults whose skeletal maturity could still be in question.

Other treatment modalities, such as bracing or physical therapy, are generally less effective for such severe cases. Bracing is typically reserved for patients with a Cobb angle between 20 and 40 degrees, where the goal is to prevent progression during growth phases. Observation is appropriate for mild curves that are not expected to worsen, and physical therapy can be beneficial for strengthening but does not correct the structural deformity in established scoliosis with significant angles.