Scoliosis is a spinal condition that can be diagnosed in both children and adults. Surgery is often recommended in severe cases as the most effective corrective option. When surgery is necessary, patients may find it reassuring to learn about the procedure, what to expect during recovery, and typical outcomes.
At Advanced Spine and Pain, our team of pain specialists has experience treating back pain with a variety of procedures, both surgical and non-invasive. If you would like to learn more about how we can relieve your back pain, contact us online or call 480-573-0130
today.
What Is Scoliosis?
Most spines have a natural front-and-back curve. Spines affected by scoliosis have a sideways curve. This can create a C or S-shaped alignment of the spinal bones, affecting posture and leading to back pain.
Most scoliosis cases are classified as idiopathic, meaning they develop without a known cause. In some cases, however, it is congenital, meaning a person is born with a curved spine.
This spinal curve is measured in degrees. Any curve measuring greater than 10 degrees results in a scoliosis diagnosis. Scoliosis can be further classified as mild (10-24 degrees), moderate (25-39 degrees), or severe (40 degrees or greater).1
Can Scoliosis Be Fixed?
Mild scoliosis may not require treatment, but if there is a significant curve, a healthcare provider will recommend treatment designed to slow the condition's progression. Without such treatment, the condition could worsen over time.
Although there is no cure for scoliosis, treatment can help to improve the curve of the spine and reduce symptoms like back pain.
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What Is Recommended For Scoliosis Treatment?
There are several options for treating scoliosis, depending on the degree of curvature and age at diagnosis. Common treatments include:
- Physical therapy
- Bracing
- Surgical treatment
In cases of adult scoliosis, managing pain can also be important. The most common cause of adult scoliosis development is degenerative scoliosis, or wear and tear due to aging and arthritis.2 This condition can lead to pinched nerves and spinal bone compression, which can cause back and leg pain that impacts quality of life. A pain specialist can help address pain due to scoliosis and may suggest options such as:
- Medications to treat pain
- Epidural steroid injections
- Nerve block injections
Choosing and Understanding Scoliosis Surgery
In cases where surgical treatment is recommended, spinal fusion surgery can help correct and stabilize the curve of the spine in severe scoliosis. Some common questions about this scoliosis surgery include:
What Is Spinal Fusion Surgery?
During spinal fusion surgery, two or more vertebrae (the bones in the spine) are joined together, helping to reduce discomfort-causing movement and preventing further progression of scoliosis.
What Are Some Risks Of Spinal Fusion Surgery?
Like all procedures, spinal fusion surgery has both risks and benefits. Possible risks include: 3
- Bleeding or blood clots
- Infection
- Spinal nerve damage, which can cause weakness, loss of bowel or bladder control, or altered sensation
- Leakage of spinal fluid (requiring a second surgery)
- Future problems with surrounding vertebrae that become worn more quickly after the procedure
- Headaches
- Reactions to the medications used during the surgery
What Happens During Spinal Fusion Surgery?
Spinal fusion surgery is a major surgery, so several steps are involved, beginning with preparing for the procedure.
Before the Spinal Fusion Surgery
A specialist will meet with the patient to discuss the procedure and make sure it’s safe for that person. This includes steps like:
- A physical exam
- Pre-surgical lab testing
- Review of current medications
- Review of medical history
- Anesthesia choices
- Recovery planning
The Day of Surgery
On the day of the surgery, the healthcare team will review several steps to ensure safety during the procedure. This includes checking vital signs, reviewing medication lists, making sure medications have been temporarily stopped before the surgery if required, and pre-surgical preparation like placing an intravenous (IV) line, signing consent forms, and marking the surgical site.
During the Spinal Fusion Surgery
A full surgical team is involved in the procedure. The site is cleaned, the patient is placed under anesthesia, and the surgery is performed.
An incision is made, and to fuse the bones in the spine, spinal fusion surgery uses bone tissue and hardware. This bone tissue can be autogenous (from the patient), from a donor, or synthetic, but the goal is to help new tissue form at the site. 4
The hardware used can be a combination of screws, plates, or rods. Non-allergenic materials can be used for those with a metal allergy.
Once the fusion is complete, the incision is closed and the patient can be moved to the recovery room. The procedure can take 1-5 hours in total.
What is the Recovery Like After Spinal Fusion Surgery?
Recovery from spinal fusion surgery requires time and rest. For the first few weeks, it’s important to observe any restrictions to activity that a healthcare provider has recommended. Typically, this means avoiding:
- Lifting, bending, or twisting
- Sitting for long periods
- Any strenuous physical activity
- Driving
During the initial recovery period, it can be helpful to have additional support in doing regular household tasks and daily activities due to limited movement. Pain medications may be prescribed to help with any discomfort as the site heals.
After four to six weeks, most patients can return to work and slowly increase activity. However, full recovery can take as long as six months and sometimes longer. During the recovery process, or usually for at least three months, a brace will be recommended to stabilize the spine as it heals. This must be worn at all times.
If any of the following symptoms are present after the surgery, it’s important that the patient’s healthcare team be notified right away:
- Redness at the surgery site
- Increasing discomfort
- Swelling or drainage at the surgery site
- Fever or chills
Does Spinal Fusion Surgery Work?
Remember, there is not a 100% cure for scoliosis. Surgery can help keep the spine more stable and reduce pain, but some pain may still be present. Surgery does not correct any underlying arthritis or other problems. Sometimes, the surrounding vertebrae are at higher risk and can wear down faster after the surgery. However, more than 50% of these surgeries are considered successful. 5
Of course, it’s important to remember that not all cases of scoliosis require surgery. In mild to moderate cases, alternative, non-invasive treatments such as physical therapy and bracing may help adjust posture and slow the condition’s progression. Speak to your scoliosis specialist before making any decisions about invasive surgery options.
Additionally, pain management may be the more pressing issue for mild scoliosis. Pain management treatments can also be pursued to relieve pain. This can include:
- Medications to treat pain
- Epidural steroid injections
- Nerve block injections
Want to Learn More About Managing Back Pain?
If you’re struggling with back pain due to scoliosis, the team at Advanced Spine and Pain can help you evaluate your treatment options and design a treatment plan to help relieve pain and improve quality of life. To schedule a consultation today, contact us online or call us at 480-573-0130
.
References
1. Cleveland Clinic. “What Is Scoliosis?” Cleveland Clinic, 26 Jan. 2024, my.clevelandclinic.org/health/diseases/15837-scoliosis.
2. “How to Manage Adult Scoliosis | Mass General Brigham.” Www.massgeneralbrigham.org, www.massgeneralbrigham.org/en/about/newsroom/articles/how-to-manage-adu….
3. Spinal fusion: MedlinePlus Medical Encyclopedia. (n.d.). Medlineplus.gov. https://medlineplus.gov/ency/article/002968.htm
4. D'Souza M, Macdonald NA, Gendreau JL, Duddleston PJ, Feng AY, Ho AL. Graft Materials and Biologics for Spinal Interbody Fusion. Biomedicines. 2019 Sep 26;7(4):75. doi: 10.3390/biomedicines7040075. PMID: 31561556; PMCID: PMC6966429.
5. D'Souza M, Macdonald NA, Gendreau JL, Duddleston PJ, Feng AY, Ho AL. Graft Materials and Biologics for Spinal Interbody Fusion. Biomedicines. 2019 Sep 26;7(4):75. doi: 10.3390/biomedicines7040075. PMID: 31561556; PMCID: PMC6966429.
References
1. https://my.clevelandclinic.org/health/diseases/15837-scoliosis
2. https://www.massgeneralbrigham.org/en/about/newsroom/articles/how-to-ma…
3. https://medlineplus.gov/ency/article/002968.htm
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966429/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913031/https://www.ncbi.n…
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