Scoliosis: Should I (or My Child) Have Surgery?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Scoliosis: Should I (or My Child) Have Surgery?
Get the facts
Your options
- Have surgery to treat scoliosis.
- Don't have
surgery. Have regular checkups to see if the curve is getting worse. Children
may wear a brace to keep the curve from getting worse.
Key points to remember
- Mild curves are usually checked by the doctor every 4 to 6 months until the bones stop growing, to be sure the curves are not getting worse.
- Moderate curves may need to be braced until the bones stop growing, to keep the curves from getting worse.
- Severe curves or moderate curves that are getting worse may need surgery.
FAQs
Scoliosis is an abnormal
curve in the spine. The spine curves from side to side in an "S" or "C" shape rather than being
straight. The spine also may be twisted.
This problem occurs most often in
girls ages 10 to 16. In general, about 1 out of 100 people have some type of spinal
curve.1
The
main type of surgery is a
spinal fusion. The curved part of the backbone is
straightened with rods, wires, hooks, or screws. Then small pieces of bone are
put over the spine. These pieces of bone will grow together, or fuse, with the
spine, holding it in the proper position.
Instrumentation without fusion is another type of surgery to straighten the spine. The doctor
attaches metal rods to the spine without fusing the bones together. This is
only done in small children. It's used when doctors don't want to fuse bones
together because it would stop growth in that area of the spine. The child
usually has to wear a brace full-time after having this surgery.
Surgery usually can improve
the curve and keep it from getting worse. Surgery may also help decrease pain
and allow you to do more of your daily activities.
Each person's
scoliosis is different. Talk to your doctor about whether surgery can help
you.
Risks of surgery to
fix a spinal curve include:
- Problems that can happen with back surgery,
such as nerve damage, lung problems, or spinal cord damage.
- No more
growth in the fused area of a child's spine. This could mean that a child may
be slightly less tall than he or she would be without fusion.
- Problems that can happen in any surgery, such as blood clots or
infection or problems from anesthesia. The risk of these problems is higher in
older adults than in younger people.
Talk to your doctor about your or your child's chances of
having problems from surgery.
Other problems include lost time at
work or school for recovery and the possible need to wear a body cast or brace
for a few months after surgery.
A severe
spinal curve that is getting worse and is not fixed with surgery is likely to
get worse.
As the spinal curve gets worse, the bones of the spine
turn toward the inner part of the curve. If the curve is in the upper part of
the spine, the ribs may crowd together on one side of the body and become
widely separated on the other side. The curve may force the space between the
spinal bones to narrow. The spinal bones may also become thicker on the outer
edge of the curve.
In severe curves, the ribs that are pulled out
of position may reduce the amount of air the lungs can hold. They also may
cause the heart to work harder to pump blood through the compressed lung
tissue. Over time, this may lead to
heart failure.
Scoliosis that is present
at birth or that occurs in infants may be worse over time than a spine that
curves later in life. If an infant or young child with a severe spinal curve
does not have surgery, it is likely that the curve will get worse. This is
because the curve gets worse as the child grows.
Your doctor might suggest surgery for you or your
child if:
- Your child has a moderate to severe curve or yours is severe, and the curve is getting
worse.
- You have pain or trouble doing your daily activities.
Compare your options
|
|
|
|
What is usually involved?
|
|
|
|
What are the benefits?
|
|
|
|
What are the risks and side effects?
|
|
|
Have surgery Have surgery
- You or your child will likely stay
in the hospital for several days after
surgery.
- You or your child will have to
spend a few weeks at home. Your child can go back to school in 3 or 4
weeks.
- For 6 to 12 months, you or your child can't do anything that
could jar the spine—such as roller skating or skiing.
- You or your child may need to wear a body cast or brace for a few
months after surgery.
- Surgery usually can improve the
curve and keep it from getting worse.
- It may decrease your pain and allow you to do your daily
activities.
- It can prevent breathing and heart problems from the
curved spine.
- Any surgery can cause
problems such as bleeding, blood clots, and infection.
Anesthesia also can cause problems.
- Back surgery has a risk of nerve damage, lung problems, or spinal
cord damage.
- In a child, spinal fusion will stop growth in the area
of the spine that is fused. This could mean that a child may be slightly less
tall than he or she would be without fusion.
Don't have surgery
Don't have surgery
- You or your child gets
checkups every 4 to 6 months to see if the curve is getting worse.
- You can take
nonsteroidal anti-inflammatory drugs (NSAIDs) for
pain.
- Children may wear a brace to keep the curve from getting
worse.
- Exercises may help back pain.
- Exercise and over-the-counter
medicines may ease your pain.
- You or your child won't have the
risks of back surgery.
- You or your child won't have to take several weeks off from work
or school.
- Wearing a brace may keep your child's spinal curve from
getting worse.
- The spinal
curve could get worse.
- If the curve gets bad enough, it could affect your breathing and
heart.
- You could have pain and trouble doing your daily
activities.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
My daughter
was diagnosed with a mild to moderate spinal curve when she was 16 years old. Tests
showed that she was almost done growing and her doctor said it was likely that
the curve would not get worse. We were relieved because we didn't want her to
have surgery, but of course we didn't want her to have problems with her back
as she got older.
When my daughter was in the sixth grade, I
noticed that her clothes seemed to hang unevenly. We looked at her back and saw
that her shoulders were not even. Her doctor examined her and took X-rays of
her spine. To our shock and surprise, she had a large spinal curve. Because
of her age, the fact that she was just starting her teenage growth spurt, and
the size of her spinal curve, it was likely that her spinal curve would get
worse. We decided that surgery would provide the best chance for stopping the
curve from growing and for stabilizing her spine.
I have lived
with scoliosis for most of my life. The curve in my back has not gotten any
worse in the past 25 years, so I guess it won't now. My mother had scoliosis
and had a lot of problems with it. So my doctor just keeps an eye out for any
changes.
I was diagnosed with scoliosis when I was
22 years old. I was lucky enough not to have any problems until recently. But
my spinal curve has gotten worse, and now, at 28 years old, my doctor said it
is likely that my curve will get so bad that it will eventually affect my
breathing. I decided to go ahead and have surgery so that I won't have problems
as I get older.
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery for scoliosis
Reasons not to have surgery for scoliosis
I want to get rid of my back pain.
Exercise and over-the-counter medicine work well to control my pain.
More important
Equally important
More important
It bothers me that my curved spine keeps me from doing a lot of the activities I like.
I'm still able to do the things I like to do.
More important
Equally important
More important
I worry that my child's spine will get worse as he or she grows.
I would rather wait and see whether my child's spine gets worse as he or she grows.
More important
Equally important
More important
I or my child can take a lot of time off from work or school to recover from the surgery.
I or my child can't take a lot of time off right now to recover from the surgery.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
NOT having surgery
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
1.
If you have any amount of spinal curve, should you get surgery?
2.
Can a brace help keep a spinal curve from getting worse in children and adults?
3.
Should you consider surgery if your child's moderate curve is getting worse?
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Key concepts that you understood
Key concepts that may need review
Credits
| Credits |
Healthwise Staff |
| Primary Medical Reviewer |
John Pope, MD - Pediatrics |
| Specialist Medical Reviewer |
Robert B. Keller, MD - Orthopedics |
References
Citations
- Hu SS, et al. (2006). Scoliosis section of Disorders,
diseases and injuries of the spine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., chap. 5, pp. 255–269.
New York: Lange Medical/McGraw-Hill.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Scoliosis: Should I (or My Child) Have Surgery?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the facts
Your options
- Have surgery to treat scoliosis.
- Don't have
surgery. Have regular checkups to see if the curve is getting worse. Children
may wear a brace to keep the curve from getting worse.
Key points to remember
- Mild curves are usually checked by the doctor every 4 to 6 months until the bones stop growing, to be sure the curves are not getting worse.
- Moderate curves may need to be braced until the bones stop growing, to keep the curves from getting worse.
- Severe curves or moderate curves that are getting worse may need surgery.
FAQs
What is scoliosis?
Scoliosis is an abnormal
curve in the spine . The spine curves from side to side in an "S" or "C" shape rather than being
straight. The spine also may be twisted.
This problem occurs most often in
girls ages 10 to 16. In general, about 1 out of 100 people have some type of spinal
curve.1
What kind of surgery can fix a spinal curve?
The
main type of surgery is a
spinal fusion. The curved part of the backbone is
straightened with rods, wires, hooks, or screws. Then small pieces of bone are
put over the spine. These pieces of bone will grow together, or fuse, with the
spine, holding it in the proper position.
Instrumentation without fusion is another type of surgery to straighten the spine. The doctor
attaches metal rods to the spine without fusing the bones together. This is
only done in small children. It's used when doctors don't want to fuse bones
together because it would stop growth in that area of the spine. The child
usually has to wear a brace full-time after having this surgery.
How can surgery help?
Surgery usually can improve
the curve and keep it from getting worse. Surgery may also help decrease pain
and allow you to do more of your daily activities.
Each person's
scoliosis is different. Talk to your doctor about whether surgery can help
you.
What are the risks of surgery?
Risks of surgery to
fix a spinal curve include:
- Problems that can happen with back surgery,
such as nerve damage, lung problems, or spinal cord damage.
- No more
growth in the fused area of a child's spine. This could mean that a child may
be slightly less tall than he or she would be without fusion.
- Problems that can happen in any surgery, such as blood clots or
infection or problems from anesthesia. The risk of these problems is higher in
older adults than in younger people.
Talk to your doctor about your or your child's chances of
having problems from surgery.
Other problems include lost time at
work or school for recovery and the possible need to wear a body cast or brace
for a few months after surgery.
What are the risks of not having surgery?
A severe
spinal curve that is getting worse and is not fixed with surgery is likely to
get worse.
As the spinal curve gets worse, the bones of the spine
turn toward the inner part of the curve. If the curve is in the upper part of
the spine, the ribs may crowd together on one side of the body and become
widely separated on the other side. The curve may force the space between the
spinal bones to narrow. The spinal bones may also become thicker on the outer
edge of the curve.
In severe curves, the ribs that are pulled out
of position may reduce the amount of air the lungs can hold. They also may
cause the heart to work harder to pump blood through the compressed lung
tissue. Over time, this may lead to
heart failure.
Scoliosis that is present
at birth or that occurs in infants may be worse over time than a spine that
curves later in life. If an infant or young child with a severe spinal curve
does not have surgery, it is likely that the curve will get worse. This is
because the curve gets worse as the child grows.
Why might your doctor recommend surgery to fix scoliosis?
Your doctor might suggest surgery for you or your
child if:
- Your child has a moderate to severe curve or yours is severe, and the curve is getting
worse.
- You have pain or trouble doing your daily activities.
2. Compare your options
| |
Have surgery |
Don't have surgery
|
| What is usually involved? |
- You or your child will likely stay
in the hospital for several days after
surgery.
- You or your child will have to
spend a few weeks at home. Your child can go back to school in 3 or 4
weeks.
- For 6 to 12 months, you or your child can't do anything that
could jar the spine—such as roller skating or skiing.
- You or your child may need to wear a body cast or brace for a few
months after surgery.
|
- You or your child gets
checkups every 4 to 6 months to see if the curve is getting worse.
- You can take
nonsteroidal anti-inflammatory drugs (NSAIDs) for
pain.
- Children may wear a brace to keep the curve from getting
worse.
- Exercises may help back pain.
|
| What are the benefits? |
- Surgery usually can improve the
curve and keep it from getting worse.
- It may decrease your pain and allow you to do your daily
activities.
- It can prevent breathing and heart problems from the
curved spine.
|
- Exercise and over-the-counter
medicines may ease your pain.
- You or your child won't have the
risks of back surgery.
- You or your child won't have to take several weeks off from work
or school.
- Wearing a brace may keep your child's spinal curve from
getting worse.
|
| What are the risks and side effects? |
- Any surgery can cause
problems such as bleeding, blood clots, and infection.
Anesthesia also can cause problems.
- Back surgery has a risk of nerve damage, lung problems, or spinal
cord damage.
- In a child, spinal fusion will stop growth in the area
of the spine that is fused. This could mean that a child may be slightly less
tall than he or she would be without fusion.
|
- The spinal
curve could get worse.
- If the curve gets bad enough, it could affect your breathing and
heart.
- You could have pain and trouble doing your daily
activities.
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.
Personal stories about surgery for scoliosis
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"My daughter was diagnosed with a mild to moderate spinal curve when she was 16 years old. Tests showed that she was almost done growing and her doctor said it was likely that the curve would not get worse. We were relieved because we didn't want her to have surgery, but of course we didn't want her to have problems with her back as she got older."
"When my daughter was in the sixth grade, I noticed that her clothes seemed to hang unevenly. We looked at her back and saw that her shoulders were not even. Her doctor examined her and took X-rays of her spine. To our shock and surprise, she had a large spinal curve. Because of her age, the fact that she was just starting her teenage growth spurt, and the size of her spinal curve, it was likely that her spinal curve would get worse. We decided that surgery would provide the best chance for stopping the curve from growing and for stabilizing her spine."
"I have lived with scoliosis for most of my life. The curve in my back has not gotten any worse in the past 25 years, so I guess it won't now. My mother had scoliosis and had a lot of problems with it. So my doctor just keeps an eye out for any changes."
"I was diagnosed with scoliosis when I was 22 years old. I was lucky enough not to have any problems until recently. But my spinal curve has gotten worse, and now, at 28 years old, my doctor said it is likely that my curve will get so bad that it will eventually affect my breathing. I decided to go ahead and have surgery so that I won't have problems as I get older."
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery for scoliosis
Reasons not to have surgery for scoliosis
I want to get rid of my back pain.
Exercise and over-the-counter medicine work well to control my pain.
More important
Equally important
More important
It bothers me that my curved spine keeps me from doing a lot of the activities I like.
I'm still able to do the things I like to do.
More important
Equally important
More important
I worry that my child's spine will get worse as he or she grows.
I would rather wait and see whether my child's spine gets worse as he or she grows.
More important
Equally important
More important
I or my child can take a lot of time off from work or school to recover from the surgery.
I or my child can't take a lot of time off right now to recover from the surgery.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
NOT having surgery
Leaning toward
Undecided
Leaning toward
5. What else do you need to make your decision?
Check the facts
1.
If you have any amount of spinal curve, should you get surgery?
You're right. Surgery is recommended only for severe spinal curve. Most spinal curves are not bad enough to need surgery.
2.
Can a brace help keep a spinal curve from getting worse in children and adults?
That's right. A brace can keep a spinal curve from getting worse only in children. It does not help adults.
3.
Should you consider surgery if your child's moderate curve is getting worse?
That's right. Doctors usually recommend surgery if a moderate spinal curve is getting worse, or for a severe curve.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Credits
| By |
Healthwise Staff |
| Primary Medical Reviewer |
John Pope, MD - Pediatrics |
| Specialist Medical Reviewer |
Robert B. Keller, MD - Orthopedics |
References
Citations
- Hu SS, et al. (2006). Scoliosis section of Disorders,
diseases and injuries of the spine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., chap. 5, pp. 255–269.
New York: Lange Medical/McGraw-Hill.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Last Revised:
July 21, 2011
Hu SS, et al. (2006). Scoliosis section of Disorders,
diseases and injuries of the spine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., chap. 5, pp. 255–269.
New York: Lange Medical/McGraw-Hill.
