Surgery

Surgery may be used to treat severe scoliosis. The goal of surgery is to improve a severe spinal curve. The result will not be a perfectly straight spine, but the goal is to balance the spine and to make sure the curve does not get worse. Surgery usually involves stabilizing the spine and keeping the curve from getting worse by permanently joining the vertebrae together.

Factors that are considered before surgery include:

• The person's age.
• The size, direction, and location of the spinal curve(s).
• Whether other treatment (such as bracing) has failed.

Surgery may be considered if:

• A child has a spinal curve greater than 45 to 50 degrees.
• The curve is expected to get worse. In children, a curve may progress because a child has not finished growing. In adults, a large curve of greater than 50 degrees may continue to get worse.³
• Bracing cannot be used or does not work.

Should I (or my child) have surgery for scoliosis?

Surgery Choices

The main type of surgery for scoliosis involves attaching rods to the spine and performing a spinal fusion, which is used to stabilize and reduce the size of the curve and stop the curve from getting worse by permanently joining the vertebrae into a solid mass of bone.

Other techniques are sometimes used, including instrumentation without fusion, a technique that attaches devices such as metal rods to the spine to stabilize a spinal curve without actually fusing the spine together. This is only done in very young children when a fusion, which stops the growth of the fused part of the spine, is not desirable. The child usually has to wear a brace full-time after having this surgery.

What To Think About

The timing of surgery for scoliosis in children is controversial. Some experts believe that surgery should be delayed until the child is at least 10 years old and preferably 12 because spinal fusion stops the growth of the fused part of the spine. However, the rest of the spine will continue to grow normally in children who are still growing.

Surgical treatment in children and teens usually requires several days in the hospital and limitations on activity for approximately a year. In adults, the average hospital stay is longer.

Adults who have surgery for scoliosis that results from changes in the spine due to aging (degenerative scoliosis) are more likely than children to have significant complications. Even though surgery usually reduces their pain, other complications may occur, such as pseudoarthrosis and wound infections.