Scoliosis in Adults:
Degenerative and Idiopathic Causes & Treatments
FACTUALLY ACCURATE & VERIFIED BY
Dr. Clayton J. Stitzel
LAST UPDATED ON
November 5, 2021
Most scoliosis surgeons agree that after age five, only a very severe scoliosis spine curve (more than 80 degrees) would be life-threatening to a child’s heart and lungs. Many studies find there is little-to-no improvement in breathing or heart function before and after scoliosis surgery. Many parents and patients are choosing to avoid scoliosis surgery entirely.
Scoliosis Surgery (Spinal Fusion): Risks vs. Benefits
Many parents and patients are choosing to avoid scoliosis surgery entirely.
Scoliosis is only life-threatening if a child younger than five years old has severe spinal deformity. Before the lungs are fully developed, there is a rare possibility that a scoliosis curvature could cause the heart to stop (cor pulmonale). Believe it or not, scoliosis surgery is not a necessary procedure to save the patient’s life in the vast majority of cases.
Yet, scoliosis spinal fusion surgery is often recommended when a scoliosis curve measures over 50 degrees. It also gets recommended before children are done growing — as young as age 14. A scoliosis operation may seem like the only option if a doctor says your child “needs it immediately”. The spine surgeons may say that back surgeries are much less invasive than they used to be, but all back surgery is invasive. The recovery from scoliosis surgery can be a long and difficult process, especially if it fuses many of the 24 vertebra. Receive free recommendations about avoiding scoliosis surgery sent directly to your email.
Table of Contents
Types of Scoliosis Surgeries
With the first spinal surgery for scoliosis taking place in 1865 (France), there certainly has been a lot of innovation in the field of surgical correction for scoliosis over the decades. The most notable was the Harrington rod surgery beginning in the late 1950’s and early 1960’s. This was a partial fusion surgery with a single rod attached to the vertebra at top and bottom of the spinal curve. The use of pedicle screw and double rod hardware (CD instrumentation) began in the mid 1980’s and introduced full back surgery with much better scoliosis curvature deformity correction. Unfortunately, this also increases the risk of many problems both short and long-term. Scoliosis vertebra tethering (fusionless scoliosis surgery) procedures (VBT and ASC) started to be utilized in the mid 2000’s and continue in their development as an internal brace.
Studies Show the Many Risks of Scoliosis Surgery
Various studies show that back surgery has many problems. These risks seem inordinate since back surgery does not:
- “cure scoliosis,”
- stop its progression (long-term),
- improve functions of the heart and lungs.
- does not improve quality of life after scoliosis surgery
- “Scoliosis approaches that violate the chest wall show a significant decline in postoperative pulmonary function.” (The effect of surgical approaches on pulmonary function in adolescent idiopathic scoliosis) Journal of Spinal Disorders & Techniques (2009)
- Back pain is not eliminated.
During a normal life span, an estimated 40-55 percent of post operative patients will suffer from long-term scoliosis surgery issues. These can range from chronic lower back pain to permanent disability.
Surgical treatment risks include:
- Implant failure
- Nerve damage
- Chronic pain
- Infection
- Bone graft procedures
- Spinal cord injury
“Spine fusion surgery for scoliosis replaces a functioning crooked spine with a non-functioning straighter one.”
Clayton J. Stitzel DC
Effective Non-Surgical Scoliosis Treatment Does Exist!
Part of the problem is non-surgical scoliosis treatment information is not always available to patients or parents. As a result, many often feel back surgery is a bad idea, yet think there are no other options. Parents and patients end up doing their own online research for terms like scoliosis surgery before and after, scoliosis surgery recovery, curvature correction, and life after scoliosis surgery.
The ScoliSMART doctors want you to know that both children and adults have non-invasive scoliosis treatment options that can help them/you live their/your best life with scoliosis. All without the high risk of complications from surgery.
To learn more about how to treat the whole scoliosis condition and not only the curve, connect with our passionate providers at ScoliSMART. To explore a non-brace/ non-surgical treatment for your child’s scoliosis problem, you may schedule a no-cost Zoom or phone consultation with a ScoliSMART doctor. Please get in touch with us today!
Exercises That Create a New (and Straighter) Scoliosis Posture Memory
Combinations of genetic variant patterns are the cause of idiopathic scoliosis. Further research on neurotransmitters and hormone imbalances strongly suggests the true cause of adolescent idiopathic scoliosis is a miscommunication between the brain and spine causes its curve progression. This creates a faulty “postural memory” your brain uses to (incorrectly) align the spine to gravity. Because it is rooted in a genetic predisposition, the patient’s brain doesn’t even realize that something is wrong!
We use patented scoliosis equipment and exercises to retrain the brain (and spine) to learn a new “posture memory” over time. Our treatments also decrease soft tissue resistance to unlock the spine. Your child’s brain and body actually learn how to hold the spine straighter. This treatment can reduce a curve, halt progression, and reduce pain for a child or an adult. It stops the progressive twisting effect. If we start this rehabilitation before your child’s curve measures 25 degrees, you will likely never have to discuss surgery with a doctor. Keeping the curve from getting worse — that is our first goal for every patient.
The Most Common Questions Parents & Patients Have About Scoliosis Surgery
Is Scoliosis Surgery Dangerous?
Scoliosis is serious. It affects you and/or your child both physiologically and psychologically. Yet, it is rarely life-threatening. All surgery is “dangerous” and contains risks that include:
- internal hemorrhage
- stroke
- blood transplants
- paralysis
- infection
- death
While modern medicine has mitigated and minimized these risks, the risk is never zero. This should be carefully considered and discussed with one’s orthopedic surgeon before committing to posterior spinal fusion for scoliosis.
What Is the Best Age for Scoliosis Surgery?
Like all conditions that may need back surgery, there are many individual variables patients (and their parents) should consider before committing to back surgery. Most orthopedic surgeons prefer to wait until patients are done (or almost done) growing. Spine surgery procedures disrupt the growth plates and prevent any further growth of the spine. But, most younger children do not have enough bone density to keep the surgical hardware from pulling out of the bones (similar to osteoporosis). They may need a bone graft before the age of 10 years old or wait until they reach skeletal maturity. Adult scoliosis or degenerative scoliosis may be candidates for surgical procedures if physical therapy and a brace are ineffective in the treatment of scoliosis.
Is Scoliosis Surgery a Major Surgery?
In a study of 118 patients ages 10-17 who underwent spinal deformity correction at least five years prior, “common symptoms included:
- occasional back pain (90, 76%),
- limited range of motion (52, 44%),
- activity limitations (54, 46%),
- waistline imbalance (41, 35%),
- rib prominence (28, 24%),
- wound/scar problems (18, 15%),
- and shortness of breath (18, 15%).
There was a high incidence of occasional back pain and activity complaints after surgery for AIS . . .”
“Health-related quality-of-life scores, spine-related symptoms, and reoperations in young adults 7 to 17 years after surgical treatment of adolescent idiopathic scoliosis,” American Journal of Orthopedics (2015)
What Is the Success Rate for Scoliosis Surgery?
The current “hooks and screws” double steel rod surgical implants can produce excellent curve reduction in curves even as high as 90–100 degrees. But, this amount of forced “correction” comes with a cost including loss of kyphosis resulting in “flat back syndrome“. The 15–20 year follow-up studies of post-scoliosis surgery patients with moderate-to-severe pain ranges from 40–55 percent. Contrasted with a 50-year follow-up study of completely untreated patients with scoliosis. They reported only mild-to-moderate pain the majority of the time.
Is Scoliosis Surgery Worth It?
Surgery is indicated for cosmetic improvement of spinal deformity and halting further progression. It has not been shown to consistently:
- reduce or relieve pain
- improve deformity of kyphosis
- improve cardiac (heart) function
- improve pulmonary (lung) function
- prevent degenerative scoliosis
- or improve the patient’s psychological well-being
While the majority of post-surgery patients do report satisfaction with their decision to undergo surgery, many of those respondents also report conflicting answers when answering more specific questions about their quality of life. This suggests a “cognitive dissonance” effect associated with their data reporting. The decision to undergo surgery is a very personal one. Short- and long-term considerations should be taken into account before a decision is made.
Can Scoliosis Come Back After Surgery?
The scoliosis condition appears to be primarily a neurohormonal condition with genomic variant predispositions. The spinal curve seen on x-ray is only the most obvious and visible symptom of the complete “scoliosis condition”. Thus surgery is only treating the condition’s primary symptom. Not the underlying scoliosis condition itself. As Dr. Paul Harrington (inventor of the Harrington rod surgery technique used throughout the 1960s through the mid 1980s) said: “Metal does not cure the disease of scoliosis, which involves far more than only the spinal column.”
After Scoliosis Surgery, Can You Bend Your Back?
Patients with fused spines have a limited range of motion in general and no motion in the areas of the hardware. While it may appear most post-surgery patients can and do have a normal range of motion, the motion is actually coming from the unfused segments. This forces more stress, wear and tear, and premature degeneration on the segments below the area of fusion, as they carry more body weight.
What Degree of Curvature Requires Surgery?
The Scoliosis Research Society (SRS) currently recommends surgical intervention for patients who have failed bracing and have curves 50 degrees or more. But, current research suggests significant lung restriction does not begin until a curve reaches 80–90 degrees.
Is Scoliosis Surgery Painful?
Yes. It is one of the most extensive and invasive orthopedic procedures performed on children or adults. It involves:
- the dissection of five layers of spinal muscles,
- removal of the vertebral posterior joints,
- insertion of a vast system of surgical hardware
- blood loss is extensive enough to require blood transfusions
- bone grafts
- 4–6-week recovery in many cases.
Long-term complications include chronic back spasms and potential metal implant toxicity from hardware breakdown (leading to permanent inflammation).
What Are the Risks of Scoliosis Fusion Surgery?
As many as one in 10 scoliosis patients will ultimately get a referral for back surgery. Each year, nearly 40,000 choose to endure this invasive procedure.
But just because a doctor recommends back surgery doesn’t mean it’s your only — or even best — option.
Before you commit to having your spine fused, it’s important to fully consider the risks of scoliosis surgery. To reach the spine, a surgeon must make an incision through five layers of spinal muscles, including surrounding ligaments, tendons and the spine’s entire posterior joint system. Stabilizing the curve involves running a solid metal rod through a column of 3-inch screws and hooks inserted into the bone along the entire length of the curve. It’s a highly invasive surgery that requires months of recovery time. At best, the procedure results in a 20 to 60 percent loss in side flexibility.
What Is the Best Age for Scoliosis Surgery?
As many as one in 10 scoliosis patients will ultimately get a referral for back surgery. Each year, nearly 40,000 choose to endure this invasive procedure.
But just because a doctor recommends back surgery doesn’t mean it’s your only — or even best — option.
Before you commit to having your spine fused, it’s important to fully consider the risks of scoliosis surgery. To reach the spine, a surgeon must make an incision through five layers of spinal muscles, including surrounding ligaments, tendons and the spine’s entire posterior joint system. Stabilizing the curve involves running a solid metal rod through a column of 3-inch screws and hooks inserted into the bone along the entire length of the curve. It’s a highly invasive surgery that requires months of recovery time. At best, the procedure results in a 20 to 60 percent loss in side flexibility.
But is scoliosis surgery dangerous? Explore the facts and decide for yourself.
Risks of Fusion Surgery
Scoliosis surgery risks include:
Implant failure:
Surgical hardware implants fail in more than half of all patients who receive them. They can break, become dislodged, pierce the spinal canal and compress nerve roots (stenosis), causing pain or disability. In one study, one in five patients with fused spines had to have their implants removed, and 22 percent of patients required a total of 28 additional operations.
Nerve damage:
Damage to the spinal nerves can leave patients with a variety of neurologic complications such as loss of skin sensation, weakness in the feet or legs, or loss of bowel and bladder control. One study found that 40 percent of spinal fusion patients were considered severely disabled after surgery. In more serious cases, patients can develop paraplegia or quadriplegia, although the risk is less than 1 percent.
Chronic pain:
Even patients whose spinal fusion is considered successful can experience back pain down the road. Up to a third of patients suffer from back pain within 5 to 7 years of their surgery.
Infection:
Every surgery carries the risk of infection because of the incision. With a procedure as invasive as back surgery, the risk is elevated. Around 5 to 10 percent of surgical patients develop deep infections a year or more after surgery. The threat of infection doesn’t disappear with time, either — some can develop as long as 8 years afterward.
During a normal life span, more than 50 percent of patients will suffer from long-term scoliosis surgery issues. These can range from chronic lower back pain to permanent disability.
Online consultation scheduling is available!
Now it’s even easier to connect with ScoliSMART. Schedule your no-cost, no-obligation phone or Zoom consultation online with a ScoliSMART physician. Visit the ScoliSMART BootCamp page and click the “Schedule Online” button at the top of the page. Then select the best date and time to connect with a physician. Schedule your consultation right here!
Worth the Risk?
The goal of scoliosis surgery is to stop the curvature from progressing while reducing the spinal deformities as much as possible. Given the heavy risks of scoliosis surgery, however, success rates remain low. In some cases, the spine fails to fuse or the curves continue to progress even after the surgery. In fact, “there is no evidence that health-related signs and symptoms of scoliosis can be altered by spine surgery in the long-term,” one study concluded.
In other words, even if the surgery does achieve some correction in patients, a full third will lose it all within 10 years. One in five will eventually need more surgery. Ask 100 post op patients if their surgery was a success, and nearly half will tell you they felt no reduction in pain, while more than a quarter will express unhappiness with the outcome.
Non-surgical Scoliosis Treatment Options
If you feel that the risks of scoliosis surgery aren’t worth the poor odds of a successful outcome, you’re not alone. You also have options.
ScoliSMART’s non-surgical scoliosis treatment program offers a much safer and more effective alternative to surgery. By using a Scoliosis Activity Suit in conjunction with specific exercises, patients can address the underlying cause of scoliosis rather than merely treating the symptom (spinal curvature). Instead of attempting to physically force the spine into normal alignment, our program creates a new and improved postural memory to reduce the scoliosis curve. Scoliosis treatment without surgery for adults is also possible at almost any age.
It works, especially in comparison to the high failure rates of back surgery for scoliosis. A recent study of ScoliSMART clinical outcomes showed an over 90 percent success rate at reducing or stabilizing scoliosis curves.
Because retraining the brain demands time and consistency, our non-surgical scoliosis treatment requires a large commitment from the patient. Then again, so does recovering from surgery. In the end, patients who choose to heal their scoliosis naturally will emerge stronger because of it.
Treating scoliosis typically involves a lot of guesswork on the part of your doctor. Not every treatment option will be right for every patient, and just because you get a recommendation for spinal fusion surgery doesn’t mean that’s your only hope. A well-informed patient making well-informed decisions has the power to ensure the best possible outcome, even with advanced scoliosis curves.
Don’t know where to start? Take our FREE “ScoliQuiz.” (No x-ray required)
ScoliSMART Clinics is committed to treating the WHOLE scoliosis condition, not only the curve. Genetic & clinical testing with targeted nutrient therapies, expert in-office treatment programs, and the world’s only ScoliSMART Activity Suit provides patients of all ages with the most comprehensive, most effective, and least invasive treatment options available worldwide.
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