Scoliosis: When Surgery is Necessary and What to Expect

Q: Scoliosis: When Surgery is Necessary and What to Expect

Hello： If your condition is indeed as significant as you mentioned, it is advisable to visit a trusted medical facility for a comprehensive evaluation. <br>Generally, it is necessary to assess whether your cardiopulmonary function is affected by the scoliosis, as well as to evalu

Scoliosis, post-spinal surgery?

Hello Dr.
You: I am 19 years old, male, and I have discovered that I have approximately 40 degrees of scoliosis in my thoracic spine.
I did some research online and found that curves greater than 40 degrees typically require surgical intervention.
I would like to know under what symptoms surgery becomes necessary.
Is it only when it affects daily life? If I choose not to have surgery, will I experience more severe symptoms as I age? Additionally, what are the potential complications after surgery? Will I be unable to participate in certain sports, and how long is the rehabilitation period? Thank you, Dr.
You.

Mr. Li, 10~19 year old female. Ask Date: 2019/11/06

Dr. You Dianqi reply Orthopedics

Hello: If your condition is indeed as significant as you mentioned, it is advisable to visit a trusted medical facility for a comprehensive evaluation.
Generally, it is necessary to assess whether your cardiopulmonary function is affected by the scoliosis, as well as to evaluate your willingness and the associated risks before determining the necessity of the surgery you mentioned.
If left untreated, it is important to be aware of the potential impacts on cardiopulmonary function and the effects of scoliosis on future spinal issues or lower back pain in older age.
If you undergo surgery, due to the longer segments involved, internal fixation devices will typically be required for adjustment.
The risks associated with anesthesia and surgery, as well as the duration of postoperative rehabilitation, are generally longer.
Thank you.

Reply Date: 2019/11/06

More Info

Scoliosis, a condition characterized by an abnormal lateral curvature of the spine, can present various challenges, particularly when the curvature exceeds 40 degrees, as in your case. At 19 years old, you are at a critical age where the spine is still developing, and understanding the implications of scoliosis is essential for making informed decisions about your health.

When is Surgery Necessary?
Surgery for scoliosis is typically considered under specific circumstances:
1. Degree of Curvature: Generally, a curvature greater than 40 degrees, especially if it is progressive, raises the concern for surgical intervention. Curvature of this magnitude can lead to significant postural changes and potential complications.

2. Symptoms: If you experience symptoms such as severe back pain, difficulty breathing, or neurological symptoms (like numbness or weakness in the legs), these may indicate that the curvature is affecting your overall health and quality of life. Surgery is more likely to be recommended if these symptoms are present.

3. Progression: If your scoliosis is worsening over time, even if you are asymptomatic, surgery may be advised to prevent further complications. Regular monitoring through X-rays can help determine if the curvature is increasing.

4. Impact on Daily Life: If the curvature affects your ability to perform daily activities or participate in sports, this may also warrant surgical consideration.

Long-term Effects of Not Treating Scoliosis
If left untreated, scoliosis can lead to several long-term complications:
- Worsening Curvature: As you age, the curvature may progress, potentially leading to more severe deformities.

- Chronic Pain: Many individuals with untreated scoliosis experience chronic back pain as they age due to uneven stress on the spine and surrounding muscles.

- Respiratory Issues: Severe scoliosis can impact lung function, leading to breathing difficulties, particularly if the curvature affects the thoracic region.

- Reduced Mobility: Over time, untreated scoliosis can lead to decreased flexibility and mobility, impacting your ability to engage in physical activities.

What to Expect After Surgery
If you decide to proceed with surgery, typically spinal fusion is performed to correct the curvature. Here’s what you can expect:
1. Recovery Time: The initial recovery period can last several weeks, but full recovery and rehabilitation may take several months. Physical therapy is often recommended to help regain strength and flexibility.

2. Post-operative Symptoms: Pain is common after surgery, but it can be managed with medication. Some patients may experience stiffness or discomfort as they heal.

3. Activity Restrictions: After surgery, there will be restrictions on physical activities, particularly high-impact sports, for a certain period. Your surgeon will provide guidelines on when you can safely resume various activities.

4. Potential Complications: As with any surgery, there are risks involved, including infection, blood loss, and complications related to anesthesia. Long-term complications can include hardware failure or the need for additional surgeries.

5. Impact on Sports and Activities: Many patients can return to sports and physical activities after recovery, but this will depend on the type of surgery performed and your individual healing process. Discuss your specific goals with your surgeon to tailor a rehabilitation plan that suits your needs.

Conclusion
In summary, surgery for scoliosis is generally considered when the curvature exceeds 40 degrees, especially if it is symptomatic or progressive. Not treating scoliosis can lead to worsening symptoms and complications over time. If you opt for surgery, be prepared for a recovery period that includes rehabilitation and potential activity restrictions. It’s crucial to have open discussions with your healthcare provider about your specific situation, the risks and benefits of surgery, and what you can expect during the recovery process. This will help you make an informed decision that aligns with your lifestyle and health goals.

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