Impact of Scoliosis Surgery on Women's Future Health and Pregnancy

The impact of scoliosis surgery on a girl's future life?

Before the surgery, the cervical spine was at 35 degrees, the thoracic spine at 48 degrees, and the lumbar spine at 26 degrees.
After the surgery, the cervical spine measured 30 degrees, the thoracic spine 35 degrees, and the lumbar spine remained at 26 degrees.
The cervical and thoracic measurements are spiral-shaped, while the lumbar spine is in a traction-induced S-shape.

I have a friend who has congenital scoliosis (she uses a towel spiral as a metaphor).
She underwent surgery to correct it with metal rods during her transition from elementary to middle school.
She is now twenty years old, and previous follow-ups indicated that the surgery was successful without major issues.

I would like to ask the physician about the implications of her condition for future pregnancies and the potential effects of aging on bone density compared to individuals without scoliosis.
Specifically, what is the increased percentage risk of developing bone-related issues or other conditions due to scoliosis or the corrective surgery?
Additionally, she mentioned that the doctor stated that a curvature of less than 26 degrees is considered standard, which is why surgery was not performed.
I would like to know how significant this curvature (the traction-induced one) could affect her future pregnancies and aging.
Compared to individuals without scoliosis, what is the likelihood of developing bone density issues or the need for further corrective surgery due to scoliosis?
I apologize for asking these questions multiple times, but I appreciate your understanding as I seek clarity on these concerns.
Thank you.

Fanren de xiao dai, 10~19 year old female. Ask Date: 2004/08/25

Dr. Yang Zhengfan reply Orthopedics

Dear Xiao Dai, many of the questions you asked still remain unanswered.
Surgery is typically recommended for scoliosis when the curvature exceeds 40 degrees because, statistically, a curvature greater than 40 degrees is associated with significant back pain and premature aging.
As for corrective surgery for scoliosis, it has only been practiced for a little over forty years, and the current methods of spinal internal fixation have only been in use for the past twenty years.
Therefore, the long-term effects on bone quality after surgery are still under investigation.

Reply Date: 2004/08/25

More Info

Scoliosis surgery, particularly in young women, raises important questions regarding future health, pregnancy, and potential complications. Your friend's experience with scoliosis and subsequent surgery is a common scenario, and understanding the implications of such a condition and its treatment is crucial for her future well-being.

Firstly, it’s essential to recognize that scoliosis, which is a lateral curvature of the spine, can vary significantly in severity. The angles you mentioned—35 degrees in the thoracic region and 26 degrees in the lumbar region—indicate a moderate to severe curvature, which can lead to complications if left untreated. Surgical intervention, typically involving the insertion of rods and screws to stabilize the spine, aims to correct this curvature and prevent further progression.

Regarding pregnancy, women who have undergone scoliosis surgery can generally have healthy pregnancies. However, there are several factors to consider:
1. Physical Changes: Pregnancy causes significant changes in a woman's body, including weight gain and changes in posture. For women with a history of scoliosis, these changes may exacerbate back pain or discomfort. It’s crucial for your friend to maintain a healthy weight during pregnancy and engage in appropriate physical activity, as advised by her healthcare provider.

2. Delivery Method: Depending on the severity of her scoliosis and the surgical correction, there may be considerations regarding the mode of delivery. While many women with a history of scoliosis can have vaginal deliveries, some may require a cesarean section, especially if there are concerns about the spine's stability or if there are complications during labor.

3. Long-term Health: As for the long-term effects of scoliosis and surgery on bone health, individuals with scoliosis may be at a slightly increased risk for osteoporosis, particularly if they have had significant spinal fusion. The fusion can limit spinal mobility, which is essential for maintaining bone density. Regular weight-bearing exercises, a balanced diet rich in calcium and vitamin D, and routine screenings for bone density can help mitigate these risks.

4. Age-related Changes: As your friend ages, she may experience typical age-related changes in bone density and joint health. However, the presence of scoliosis and prior surgery could potentially increase the likelihood of developing issues such as arthritis or degenerative disc disease. Regular check-ups with a healthcare provider specializing in spinal health can help monitor these changes.

5. Risk Factors: While it is challenging to quantify the exact percentage increase in the risk of developing bone-related issues or other complications due to scoliosis surgery, studies suggest that individuals with untreated scoliosis may face more significant health challenges compared to those who have received appropriate treatment. The key is to maintain a proactive approach to health, including regular medical evaluations and lifestyle modifications.

In summary, while scoliosis surgery can have implications for future pregnancies and long-term health, many women lead healthy lives post-surgery. Your friend should maintain open communication with her healthcare providers, including obstetricians and orthopedic specialists, to ensure a comprehensive approach to her health as she considers pregnancy and navigates aging. Regular monitoring and a proactive approach to health can help mitigate potential risks associated with her condition.

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