Scoliosis - Braces

Surgery

The goals of scoliosis surgery are threefold:

• Straighten the spine as much as possible in a safe manner
• Balance the torso and pelvic areas
• Maintain the correction long-term

It takes a two-part process to accomplish these goals:

• Fusing (joining together) the vertebrae along the curve
• Supporting these fused bones with instrumentation (steel rods, hooks, and other devices) attached to the spine

There are many surgical variations that use different instruments, procedures, and surgical approaches to treat scoliosis. All of the operations require meticulous skill. In most cases, success depends less on the type of operation than on the skill and experience of the surgeon.

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The cause of scoliosis often determines the type of procedure. Other determinants include the location of the curve (thoracic, thoracolumbar, or lumbar); single, double, or triple curves, and any rotation that may be present; and how large the curve is.

Parents of patients or adult patients should not be shy in asking the surgeon and hospital about their experience with the specific procedures being considered.

Surgical Candidates

Idiopathic Scoliosis. Surgery is usually recommended for the following children and adolescents with idiopathic scoliosis:

• All young people whose skeletons have matured, and who have a curve greater than 45 degrees.
• Growing children whose curve has gone beyond 40 degrees. (There is still some debate, however, about whether all children with curves of 40 degrees should have surgery.)

Neuromuscular Scoliosis (such as meningomyelocoele and cerebral palsy). If performed, surgery is done when curving has progressed to 40 degrees or more in patients younger than 15 years old. However, this patient group is considered to be at increased surgical risk, particularly those patients with feeding problems, malnourishment, or respiratory difficulties due to the scoliosis. They also have an increased risk of bleeding complications.

Congenital Scoliosis. These children are at a higher risk of neurological injury when having surgery. However, chances for success are higher when surgery is performed at a younger age.