Sometimes a doctor may recommend spinal fusion surgery. A family may decide its best to have the surgery during adolescents. And other times, adults may decide to have surgery later in life. Decisions around scoliosis surgery vary, and the best choice depends upon the individual.
If the curve progresses past 45 to 50 degrees, most scoliosis surgeons recommend surgery. The main type of surgery for scoliosis is spinal fusion surgery. The surgery involves realigning and fusing together the curved vertebrae so that they heal into a single, solid bone. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together. Spinal fusion surgery has varying but high rate of complications, and long-term risks of scoliosis surgery have not yet been reported upon in research.[1] Complications of spinal surgery may include bleeding, infection or nerve damage.
Expanding rods and vertebral body tethering are newer types of surgery for scoliosis. Expanding rods involve two expandable rods along the spine that can adjust in length as the child grows. The rods are lengthened every 3 to 6 months either with surgery or in the clinic using a remote control. Research shows that expanding rods have a 44.5% complication and 33% unplanned revision rate.[2]
Vertebral body tethering involves screws placed along the outside edge of the spinal curve and a strong, flexible cord is threaded through the screws. When the cord is tightened, the spine straightens. As the child grows, the spine may straighten even more. Research shows that vertebral body tethering has a 26% complication and 14% reoperation rate.[3]
Doctors may recommend spinal fusion surgery for select patients who do not respond to non-operative treatment after a period of time, have curves that exceed 50 degrees and have significantly impairment to daily function, experience a worsening in lung or neurological function, or cannot stand upright to perform activities of daily living.
The main type of surgery for adults is posterior spinal fusion with instrumentation. The surgery involves realigning and fusing together the curved vertebrae so that they heal into a single, solid bone. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together.
Complications of scoliosis surgery in adults can include:
Working with people who experienced scoliosis surgery is one of the things we do best at Wellness In Motion. Our founder, Jen Gorman, is one of a few people in the United States that teaches small group classes and private sessions specifically for people with multi-level spinal fusions due to scoliosis. Read her thoughts about spinal fusion surgery.
First and foremost, we help you understand your spinal fusion, scoliosis curve pattern, and some things about scoliosis spinal fusions in general. We love to educate! We also focus on unloading the adjacent segments to the spinal fusion and stabilizing them. This focus goes hand in hand with increasing core muscle strength and postural training. Increasing core muscle strength helps stabilize the spine, supporting both the fusion and the adjacent segments. Postural training helps resist gravity and compression.
And finally, we love to work on functional strength and brainstorm lifestyle ideas so that you can keep doing the things you love with the people you love.
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