Scoliosis surgery, like all surgical procedures, comes with its share of risks and potential side effects, which is why I want patients to fully understand how the surgery affects the spine. For those choosing to forgo a surgical recommendation, there is a conservative treatment approach, with proven results, that helps patients avoid the need for invasive spinal fusion.
There are different approaches to treating scoliosis, both surgically and nonsurgically. When successful, scoliosis surgery can work by straightening a crooked spine, but the way it’s achieved can cost the spine in terms of its overall health, strength, and function.
Before getting to the specific of scoliosis surgery and how it works, let’s start with defining scoliosis, and how a diagnosis is reached.
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Scoliosis is a structural spinal condition that involves the development of an unnatural sideways spinal curve, with rotation, making it a 3-dimensional condition.
It also has to have a minimum Cobb angle of 10 degrees to be diagnosed as scoliosis, and this is a measurement taken during X-ray that tells me how far out of alignment a scoliotic spine is, and classifies conditions based on severity:
Mild scoliosis: Cobb angle measurement of between 10 and 25 degrees
Moderate scoliosis: Cobb angle measurement of between 25 and 40 degrees
Severe scoliosis: Cobb angle measurement of 40+ degrees
Very-severe scoliosis: Cobb angle measurement of 80+ degrees
Scoliosis is as progressive condition, meaning it has it in its nature to worsen over time, especially if not treated proactively, or left untreated.
Condition severity helps shape the design of effective treatment plans, and is also an important factor when it comes to becoming a surgical candidate.
For those on the path of traditional treatment, it’s likely they will be funneled towards spinal fusion surgery.
Traditional treatment doesn’t have a strategy for treating scoliosis while mild, so recommends watching and waiting for signs of further progression; the issue I have with this, however, is that it’s wasting valuable treatment time.
As a progressive condition, we know scoliosis is going to get worse at some point, so why passively wait for something we know is going to happen, meanwhile the curve is progressing unimpeded and becoming more complex to treat.
Once a patient undergoing traditional treatment crosses into the severe classification at 40+ degrees, and shows signs of continued progression, they become surgical candidates, and this is when patients have a big choice to make: whether to treat their condition surgically or nonsurgically.
So for those wondering, does scoliosis surgery work, the answer will be case-specific and will also depend on the enquirer’s definition of work.
Can scoliosis surgery straighten a crooked spine, yes, but does the way in which it’s achieved work in all areas, such as preserving natural spinal function: not always.
Officially known as spinal fusion, there are different types of scoliosis surgery, but most often, the procedure involves fusing the most-tilted vertebrae, at the curve’s apex, into one solid bone.
The vertebrae are fused together, and discs that sit between adjacent vertebrae are removed, and most often, rods are attached to the spine with pedicle screws to hold the spine in place.
The spinal discs provide cushioning, structure, and act as the spine’s shock absorbers.
The goal of spinal fusion is to stop progression, and it does so by fusing the curve’s most-tilted vertebrae together so they can’t move and become more tilted over time (progress).
So what scoliosis surgery does is eliminate movement in the spine’s fused section, but it’s important to understand the procedure’s long-term effects.
Is Scoliosis Surgery Permanent?
Once a spine is fused, it’s fused for life. In fact, if a fusion is unsuccessful at stopping progression and/or there is a hardware issue, or adverse reaction to hardware used, the only recourse is more surgery.
In addition, the way in which the procedure can impact the spine is permanent, so let’s talk about some of the short- and long-term effects associated with spinal fusion surgery.
All surgical procedures come with their share or risks, and spinal surgery is no exception. Some risks associated with the spinal fusion procedure itself can include:
In addition to the procedure’s short-term risks, there are also its long-term effects to consider:
There is no way to fully predict how a patient will respond to spinal fusion, so a complication or side effect that one patient experiences isn’t necessarily indicative of what others will face; however, the risk is there so should be considered carefully.
So if scoliosis surgery has worked in terms of straightening the spine and progression seems to have stopped, it can still affect the spine and quality of life moving forward.
The biggest complaint I hear from patients post-spinal fusion is the loss of spinal flexibility and range of motion, which, again, not every patient will experience to a noticeable degree, but it is a common outcome.
Fusing the vertebrae together to eliminate movement is contrary to the spine’s movement-based design, and removal of discs between fused vertebrae impacts the spine’s function and overall health.
The spine’s natural curves make it stronger, more flexible, and better able to distribute/absorb mechanical stress incurred during movement, so a spine that’s held in place through artificial means is not going to function in the same way.
The loss of movement can make surrounding muscles sore and stiff, and the tight and rigid spinal section can also be painful; for those who experience a noticeable loss in flexibility and motion, activity restrictions and being unable to participate in once-loved activities can impact overall quality of life.
So effects that a patient experiences, such as increased pain and/or a reduced range of motion and spinal flexibility, like the procedure itself, will be permanent.
For those wanting to forgo a surgical recommendation, or simply want to try a less-invasive form of treatment first, there is a conservative treatment approach with proven results.
Here at the Scoliosis Reduction Center, I believe in the power of prevention through the application of proactive treatment started as close to the time of diagnosis as possible.
Rather than watching and waiting, treatment is started as early in the condition’s progressive line as possible.
Where a scoliosis is at the time of diagnosis is not indicative of where it will stay; only proactive treatment can counteract the condition’s progressive nature.
As a 3-dimensional condition that ranges so widely in severity, the complex nature of scoliosis necessitates a customized treatment approach.
As a structural condition, scoliosis has to, first and foremost, be impacted on a structural level, and I work towards this through a series of chiropractic techniques and manual adjustments that can reposition the most-tilted vertebrae back into alignment with the rest of the spine.
Unlike spinal fusion that fuses the most-tilted vertebrae together to control progression, conservative treatment has the goal of achieving corrective results, in the form of an actual curvature reduction and increasing core strength.
Reducing the unnatural spinal curve doesn’t mean the spine can’t move and/or function as it should, as is the case with spinal fusion; it means the condition’s underlying structural nature has been impacted, while preserving as much of the spine’s natural function as possible.
By also integrating scoliosis-specific physical therapy, corrective bracing, and rehabilitation, conditions can be impacted on every level, and increasing core strength through physical therapy and the use of scoliosis-specific exercises (SSEs) means the spine is optimally supported by its surrounding muscles.
So to clearly answer the question, does scoliosis surgery work, yes, it can. Is spinal fusion guaranteed to work: no, it’s not.
In fact, even when spinal fusion has worked in the sense of straightening a scoliotic spine and preventing further progression, its short- and long-term effects can be serious.
From fusing vertebrae together, movement in the area is affected, and many patients are disappointed with their reduced spinal flexibility and range of motion impacting their overall quality of life.
Here at the Center, I want patients to experience the benefit of a less invasive and risky form of treatment: one that works towards preventing progression, escalating symptoms, and the need for more invasive forms of treatment in the future through a proactive and integrative conservative treatment approach.