Surgery for scoliosis, particularly in adolescents, is recommended when the curve in the spine is greater than 40 degrees and continues in its progression. For most patients, surgery is recommended when the curve is greater than 50 degrees. Surgery, when successful, can correct a curvature by 50 percent, leading to a better quality of life and better mobility. Surgery can also prevent further progression of the condition.
Approaches to Scoliosis Surgery
There are several approaches to scoliosis surgery, but there are some common elements. These elements include the use of screws and hooks that are used to anchor the spine to long rods. The rods hold the spine while bone that is added to the spine fuses with what was already there. Once the fusion process is complete, the spine doesn’t move and the curve is unable to progress. The rods are used as temporary splints that hold the spine while the bones naturally fuse. The bones should be holding the spine in place on their own, although the rods aren’t usually removed since removal isn’t necessary. The only issue is that a rod can irritate the surrounding soft tissue. If this occurs, then it needs to be removed.
This surgery can be performed posteriorly by going through the back to the spine or anteriorly by approaching the spine from the front. Which approach is recommended depends on the curve’s location, the type, and the severity. If the surgery is performed anteriorly, an incision is made in the front of the body. The organs are bypassed (moved out of the way) so that the affected area can be operated on. Blood vessels may need to be retracted.
Posteriorly, an incision is made in the back. The muscles have to be stripped from the spine so that the surgeon has access to the area. In both the posterior and anterior approaches, bone is added to the spine for the purpose of fusion. Once the rods are implanted and the surgery is complete, the recovery process begins. Patients are encouraged to move around as soon as possible.
Possible Risks of Scoliosis Surgery
As with any surgery, there are risks. These risks can include:
- Excessive blood loss
- Spinal fluid leak
- Broken rods
- Fusion failure (in less than 5 percent of cases)
- Continued curve progression
- Infection (less than 1 percent of patients)
- Hooks or screws dislodging (rare)
It is important to discuss these risks with your doctor. The specifics of your condition may put you more at risk for some events. Knowing those risks can help you make an informed decision about having surgery.
Recovery from Scoliosis Surgery
The recovery process can take a while. Jarring activities or physical contact may be restricted for 6 to 12 months. Monitoring must occur for up to two years after surgery to ensure the bone properly fused and that no further treatment is needed. Some patients can resume old activities or even begin new ones because of the success of the surgeries. Women who have had the surgery can go on to have children and do so naturally. In other words, life can become rather normal after successful scoliosis surgery.