At what degree of spinal curvature should I consider referring a patient for specialist assessment?

Consider referring a patient for specialist assessment if the spinal curvature (scoliosis) is significant or associated with concerning features. While the provided UK guidelines do not specify an exact degree of spinal curvature for referral, clinical practice generally considers referral when scoliosis is moderate to severe, typically around 20 to 25 degrees or more, or if there is evidence of progression, neurological symptoms, or functional impairment.

In children, referral is recommended if spinal deformity such as scoliosis is detected on examination, especially if accompanied by red flags like neurological symptoms, pain at night, or functional impairment.

For adults, referral to specialist spinal services or surgery is considered if there is suspected spinal fracture or significant deformity requiring surgical opinion.

Therefore, the decision to refer should be based on the degree of curvature combined with clinical features such as pain, neurological signs, progression, or functional impact rather than a strict numerical threshold alone.

For precise management, local protocols and specialist advice should be sought.

References: NICE CKS, NICE NG41