When is surgery recommended?

Surgery for scoliosis is only recommended for patients with curves that are greater than 40 degrees and rapidly progressing, and for those with curves that are greater than 50 degrees. The main objective of scoliosis surgery is to fuse the spine in order to stop the curve from progressing into adulthood.

Curvatures that are greater than 50 degrees are considered severe and are likely to progress in adulthood. A curve in the spine, when allowed to progress to more than 70 degrees, will not only cause disfiguring deformity, the body's cardiopulmonary functions may also be compromised due to shut down of space for heart and lungs.

Scoliosis surgery, besides preventing curve progression, is able to reduce curvature by about 50% with the use of modern instrumentation.


What type of surgery is performed?

Scoliosis surgery involves metal rods being fixed to hooks and screws which are applied earlier to the spine. The rods act like a splint holding the spine in place while the bone fuses together. Once the bone fuses, the spine becomes rigid, effectively stopping further curve progression. By then, the fused spine can hold itself in place. The rods, which become redundant, are usually not removed because that alone requires another major surgery.

In preparation, patients will usually be asked to donate their own blood for use during surgery. Surgical procedure is carried out under general anaesthesia.


POST SURGICAL

Following the surgery, patients can usually start moving about 2 to 3 days later. Hospital stay usually last between 4 and 7 days. Patients can normally return to school about 2 to 4 weeks after surgery.

Activity is limited for about 6-12 months while the bone is fusing. The more the spine is immobilised, the better and faster is the fusion. For that purpose, some surgeons may prescribe wearing a back brace for a period of time after surgery. Lifting, bending and twisting are strongly discouraged for the first three months after surgery.

Generally, patients will be scheduled for periodic reviews and x-ray examinations for 1-2 years after the surgery. Once the bone is solidly fused, no further treatment is required.

Normally, bone fusion has no major consequences to the daily life of the patient, short or mid- term although inevitably, there is some restriction of movement. Female patients can still be pregnant and deliver babies naturally.