This is when scoliosis surgery is needed
Scoliosis, an abnormal side-to-side curvature of the spine, affects approximately 6-9 million people in the U.S., according to the American Association of Neurological Surgeons. Although more often seen in girls, scoliosis can also affect boys. The most common form of scoliosis is known as adolescent idiopathic scoliosis, which appears in children around 8-16 years of age. There are some other types that occur even earlier in a child’s life.
Adolescents are frequently screened for scoliosis at pediatrician visits. Sometimes screening takes place in schools as well. Very often, parents notice a curvature of the spine, unequal shoulder heights or asymmetry of the rib cage anteriorly. If you notice any of these signs in your child, speak with their pediatrician.
We frequently screen a child for scoliosis because we want to catch it early. This is because bracing works and can prevent surgery if started early enough. Children with moderate scoliosis who are still growing can be prescribed a brace, and when worn consistently, this brace treatment can prevent progression of the curve to the surgical range.
Scoliosis curves worsen as children grow. Children who reach their full adult height before their curves reach 50 degrees will not have any progression or worsening of their curve in adulthood. However, once a curve reaches 50 degrees, there is a high probability that it will continue to progress even in adulthood. That is why curves over 50 degrees are treated surgically.
When necessary, scoliosis surgery usually takes place between the ages of 13-18. Surgery most often consists of a posterior spinal fusion, where the vertebrae are moved into a straighter position and then fused together. Even though the vertebrae are fused, patients do not usually lose a lot of motion because the vertebra of the thoracic spine, where scoliosis usually occurs, have very little motion due to the attached ribcage.
Whether treated with observation, bracing or surgery, the outcomes for children with scoliosis are generally good. The vast majority will return to playing sports and are able to have active lives. The rates of disabling back pain are not much higher than people without scoliosis when appropriately treated. This is true even at long-term follow up when looking at older adults who had scoliosis treatment earlier in their lives as adolescents.
Dr. David Fralinger is a pediatric orthopedic surgeon at Advocate Children’s Hospital. If you have any questions regarding scoliosis or other problems of the back or spine, please call (708) 684-5137. Learn more about scoliosis at advocatechildrenshospital.com.
About the Author
Dr. David Fralinger is a pediatric orthopedic surgeon at Advocate Children's Hospital.