Scoliosis Surgery Program

Scoliosis is an excessive or abnormal curvature of the spine. Most of the time, it can be managed nonoperatively with close monitoring and/or bracing. If scoliosis reaches a certain point, however, further progression is likely. Without additional intervention, scoliosis can affect quality of life, cause pain or even impact the function of organs like the lungs. The need for surgery is uncommon, required in fewer than one in every 1,000 patients.

Scoliosis is grouped into types, depending on the cause and the age of the patient. An annual exam performed by a pediatrician or school nurse usually reveals the curvature of the back. This is followed by prompt referral to a specialist. The specialist then performs a detailed physical exam and may request specialized spine X-rays and a subsequent MRI if necessary. After this assessment, a treatment method is recommended, taking into account individual considerations and evidence-based guidelines. 

Adolescent scoliosis is the most common type of scoliosis. It generally occurs in patients with no other known medical conditions, and its cause is not entirely clear. Treatment for this form of scoliosis depends on how much growth the patient will undergo before reaching skeletal maturity and on the severity of the curve. While it can often be managed nonoperatively, for patients with curves greater than 45 to 50 degrees, surgery is typically required.

Posterior spinal fusion is a surgical procedure generally performed to treat adolescent idiopathic scoliosis. This procedure involves making an incision in the middle of the back and exposing the spine. Screws are then carefully placed in the appropriate bones of the spine (vertebrae), and specialized rods are then connected to the screws. Together, these implants straighten the spine and maintain it in an improved position. Bone graft is frequently used to promote healing of the bone in its new alignment. Over time, the bones grow together, preventing recurrence of the curve.

Scoliosis surgery generally requires a hospital stay of three to five days. The duration of the stay depends on the complexity of the surgery and patient considerations. Once discharged, a brace is generally not needed, and patients are encouraged to resume normal everyday activities as soon as possible. Patients usually return to school within three to five weeks and can resume unrestricted sports activities within six months.

Early-onset scoliosis is defined as a curvature of the spine occurring in patients under age 10 and is treated slightly differently than scoliosis in older children. Scoliosis that affects young children often requires a growth-friendly surgical approach, which allows for curve control while maintaining growth of the spine and thorax. These patients merit additional consideration due to associated conditions like poor pulmonary function.

The surgery generally performed for early-onset scoliosis involves making a number of small incisions. Screws are carefully placed in the lower and upper bones of the spine (vertebrae), and a magnetically-controlled growing rod is then connected to the screws. Once the wound has healed, a magnet can be placed over the rod for a short period of time, resulting in a gradual lengthening and straightening of the spine. These lengthening procedures are scheduled every three to six months throughout the period of growth. Other surgical techniques are also employed when appropriate, including a vertical expandable prosthetic titanium rib (VEPTR), Shilla implants and traditional growing rods.

Scoliosis surgery generally requires a hospital stay, the duration of which depends on the complexity of the surgery and patient considerations. Once discharged, a brace is generally not needed, and patients are encouraged to resume normal everyday activities as soon as possible.