Living with a significant scoliosis can be a real challenge. Each day can bring pain, discomfort and embarrassment with physical appearance. There is also the fear of your curve progressing. Sometimes people might think that scoliosis surgery is their best (and only) option. They don’t know that there is an alternative to surgical intervention. This article will explain how surgery for scoliosis works and also will describe non-invasive treatments, which can be just as effective and bring less of a risk. It’s your choice, and you need to be educated to make the best choice for you!
When Is Scoliosis Surgery Necessary?
Did you know that in most cases of even severe scoliosis, surgery is an elective procedure rather than a necessity? In fact, only 0.1% of scoliosis cases actually require surgical intervention. In most cases, surgery is recommended by a doctor because they are either not aware that there are modern and effective non-invasive options available or they mistakenly believe they don’t work.
Before considering surgery, patients and parents should be aware of the reasons that surgery is necessary (or not necessary) and potential complications that can arise from a major spine operation.
There are specific situations in which surgery is likely the correct choice.
- Chronic and intractable pain. Patients experiencing very strong levels of pain that impede their daily activities may need surgery as a last resort to achieve pain control. Patients where scoliosis is combined with advanced spinal degeneration, spinal stenosis, or lateral listhesis; could be subject to severe and crippling pain, possible nerve damage, or even fractures from osteoporosis. In these cases, surgery can be necessary.
- Loss of bladder or bowel control due to nerve or spinal cord damage. This is considered a surgical emergency.
- Weakness or withering of an arm or leg due to nerve damage from pinched nerves associated with scoliosis.
- Compromised lung and heart function. In a small proportion of individuals with severe scoliosis in the upper back, the distortion of the rib cage can affect one’s capacity to breathe normally or the normal function of the heart. In cases of severely compromised heart or lung function, scoliosis surgery can be necessary.
- Postural collapse. In cases of very large scoliosis, the posture can collapse. This is a very painful and disabling condition and warrants a large and invasive surgery as the only means to reduce the collapse and improve posture.
If none of these five situations apply to you, non-invasive measures may be a great option to improve your scoliosis pain, improve cosmetics, and give you the skills to avoid curve progression.
Non-invasive treatments can be effective with both adolescent idiopathic and degenerative forms of scoliosis.
Treating scoliosis in a non-surgical manner utilizes custom-designed exercise programs, over-corrective 3D modern bracing, rehabilitative procedures, specific isometric exercises, along with targeted stretching protocols.
Surgery For Degenerative and Idiopathic Scoliosis
Depending on the age of the patient and severity of the curve, there are various types of surgery that are recommended. The goals of each of these surgeries are to stop the progression and attempt to reduce the size of the scoliosis along with improving the patient’s posture.
The most common of these is rod surgery with spinal fusion. In this technique, two or more vertebrae are permanently joined to create a single, rigid section of spine that is no longer capable of moving. Rods of various steel alloys are attached directly to the spinal bones to stabilize the fused area.
Very young children with scoliosis are often recommended for surgery that involves replacing the rods at regular intervals. In this procedure, rods are attached to a child’s spine to stabilize the curvature while they continue to grow. Use of this procedure could mean 10 or more spine surgeries over the child’s early years until they reach complete bone maturity, and sometimes a final fusion surgery. A new technique uses the MAGECTM (MAGnetic Expansion Control) System. Here the rods can be expanded remotely and so less surgery is needed.
Surgeons who choose to fuse a child’s vertebrae in girls younger than 10 or boys younger than 12 run the risk of minimizing their capacity for healthy lung growth and can result in an unusually short torso.
Other methods that are less invasive include Vertebral Body Tethering (VBT), Vertebral Body Stapling (VBS), and ApiFix. All three of these systems involve attaching hardware to the spine in an effort to straighten out a patient’s curves as they grow. By implementing screws or implants on only one part of the spine, it allows the body to utilize its natural ability to correct itself over time. Only selected patients are eligible for these less invasive scoliosis operations.
Details Of Scoliosis Surgical Treatment
For video of scoliosis surgery click the checkbox below. (WARNING VERY GRAPHIC)
WARNING VIDEO CONTAINS GRAPHIC CONTENT! (click to play)
Patients should be aware that undergoing scoliosis surgery brings substantial risks. In general, the process for spinal fusion is as follows:
- Individuals are administered anesthesia for the 4 to 6 hours duration of surgery.
- A variety of incisions can be made to access the spine. These can include a posterior (back), anterior (front), or lateral (side) approach. Sometimes a combined approach is used, some use thoracotomy to access the spine through the chest.
- The spine is realigned using a variety of metal tools. Often times the spinal joints are also removed and replaced with grafted bone. Patients may have bone material removed from another part of their body, called an autograft, or could use supplies from a bone bank or a synthetic material. These outside sources are not always as successful as the body may reject these materials.
- Some individuals undergo multiple sets of surgery for very large curves. In this instance, stage one has the spine released by cutting muscles and ligaments surrounding the curvature, and the patient is placed in halo-femoral traction for several weeks. During this time, the spine is able to lengthen and then will be fused during the stage two procedure.
Recovery And Prognosis After Scoliosis Surgery
Such a comprehensive surgery requires a substantial recovery period. Time spent in the hospital in a postoperative capacity will vary, but most patients are confined to their bed for 3 to 4 days.
During this time, a variety of tubes may be utilized to drain excess chest fluid if a thoracotomy was performed, and catheters and IV fluids help to maintain the body’s normal ingestion and elimination functions. Many patients experience pain during recovery, and require an epidural initially before moving to pain killing shots, pills, or an IV pump. Rarely children who undergo scoliosis surgery may be placed in a temporary body cast or rigid brace.
Patients don’t realize that it takes time before they will see tangible results from their surgery. Although the spine might initially look straighter, it takes 3 months for the spine to substantially fuse and up to 2 years for the fusion to be complete.
Non-surgical scoliosis specific exercise based treatments can yield meaningful results in as little as two weeks, and do not involve the pain and risk of surgery. While these non invasive approaches are not always the right way to go, the majority of scoliosis patients will benefit greatly from a non surgical decision.
Risks Both During And After Surgery
Nearly all surgical procedures carry a certain element of risk, but specifically, spinal surgery can bring concerns both during and after the procedure, including:
- Reactions to anesthesia or postoperative pain medication
- Bleeding, blood clots, or infection
- Gallstones or inflammation of the pancreas
- Intestinal blockage
- Excessive blood loss that requires a transfusion
- Nerve damage resulting in muscle weakness or paralysis
- Lung problems up to 1 week after surgery, with normal breathing function returning within 1 to 2 months after the procedure
Other serious conditions can also develop months or even years after surgery, again calling into question the decision to undergo a substantial elective surgical intervention in the absence of the 5 indications listed above. Long-term concerns include:
- Pseudarthrosis – A painful condition where a false joint grows at the location of the fusion. This is caused when the surgical site does not heal properly or doesn’t heal at all.
- Back pain – Individuals with a fused spine have limited mobility, which can cause stress on the back and ultimately lead to disc degeneration.
- Broken or displaced hardware – A metal rod or hook that keeps the spine in place may move, rub, or break. This can lead to pain and other complications.
- Compensatory curves – New curves or scoliosis can develop in other areas of the spine in an effort to compensate for the fused vertebrae. This more commonly occurs in children who have had surgery before reaching skeletal maturity.
In an unfortunately large percentage of patients there is the need to undergo revision surgery to correct a variety of issues that occurred during their initial procedure. Often also termed “salvage surgery,” revision surgery is an attempt to readdress a patient’s scoliosis and reposition or replace hardware, or can happen to treat an infection or deformity. Long-term rates of revision surgery can exceed 25%. Bottom line: deciding to have a scoliosis operation may lead to a second more invasive operation.
Alternatives To Scoliosis Surgery
Given that scoliosis surgery brings a fair amount of risk both during and after the procedure, with the chance of complications for years down the road, why would someone opt for this procedure without considering alternatives?
If you’re looking to halt the progression of scoliosis, reduce scoliosis curvature, improve posture, or reduce pain, you’ll be pleased to know that Strauss Scoliosis Correction has helped patients regain their life again through completely non-invasive methods.
One of our patients, Richard W., shared his experience with us about how our methods compare to the potential of surgery:
“I didn’t want to go through scoliosis surgery and so investigated alternative treatment options. Strauss Scoliosis Correction happened to be close to my home.
I am very satisfied. Everybody was pleasant and cordial. Dr. Strauss was able to answer all my questions. What is important to me, is that I learn as much as I can about my own body and receive individually-based treatment.
Do your research. Surgery is only justified in a few extreme cases, has high rates of complication, and does not guarantee improvement. If you are a teenager with scoliosis, be sure to wear your brace, if you have one, and do your CLEAR exercises. As someone who didn’t learn about these until his 20s, let me tell you that chronic physical pain is not something I would recommend—preventive healthcare is always, always your best option.”
Mandy M. traveled to us from South Africa and is nothing but pleased with her experience:
“The improvement I experienced the first time I was here prompted me to come back again. Very Satisfied. All staff and Dr Strauss are professional and caring and go out of their way to make the experience as comfortable as possible.
After treatment, when back home, I am so pleased that I am able to send photos to Dr Strauss and receive feedback. I consider this a huge benefit.
I had always been led to believe that my scoliosis would continue to progress as I aged and eventually I would have no other choice than surgery. Dr Strauss has changed all this for me. My scoliosis has improved more than I thought was possible. I am able to manage my scoliosis much better with the home programme. I am not in pain and psychologically, I no longer find the scoliosis as terrifying as I did before. Finding Strauss Scoliosis Correction has been an enormous blessing!”
Children also experience huge success with the Strauss Method, as Laura’s mother explains:
“I was searching on the internet for scoliosis treatments and I found your center. HVS homepage was very impressive. I read the homepage, watched the videos, and decided to come here for treatment. In Europe there weren’t scoliosis treatments like CLEAR, and we wanted to try this method. We would like to do anything to improve our daughter’s scoliosis to avoid surgery and wearing a brace for years.
We didn’t regret it! Laura’s back got better. It improved a lot. It was good to be here, and to return for a 1 week follow up treatment. And the results are really impressive for Laura (for us).
We are satisfied with the program. Dr Strauss told us the proper information, and everybody in the staff was very kind and helpful. Thank you all for your help in everything.
I suggest this kind of treatment to everyone who has scoliosis. The treatment is not painful, and the exercises are not complicated, but effective. I would recommend to come here, and try this treatment before surgery. It’s worth it. Surgery would be the last thing to do, when nothing helps. Conservative therapies can help to avoid surgery. I believe in this. To do these exercises are not a big effort, but with them you can have a big gain.”
For more information about how you can avoid scoliosis surgery or if you would like a second opinion, please call Strauss Scoliosis Correction at: