Risks and Improvement Rates of Scoliosis Surgery for Teens

Risks and Improvement Percentages of Scoliosis Surgery

My daughter, who is in the ninth grade, has scoliosis (in the thoracic spine, T6-T9) that was originally measured at 38 degrees (she wore a brace for over a year to manage it), but it has now worsened to 50 degrees.
The doctor has recommended surgical intervention, but I am concerned about the potential risks of the surgery and the degree of improvement it may provide.
I am even more worried about possible long-term complications that could affect her for the rest of her life.
I would like to ask for advice from a physician's perspective as well as from a family member's perspective (hypothetically).
Are there truly no other options besides surgery? Thank you sincerely.

Miss Wang, 40~49 year old female. Ask Date: 2005/05/16

Dr. Shi Guozheng reply Orthopedics

The primary goal of surgery for scoliosis is to improve its appearance.
If there is no compression of the heart or lungs, surgery may not be urgently required.
Typically, surgery is less controversial when the curvature exceeds fifty degrees.
There are inherent risks associated with surgery, which may include nerve damage, infection, or inadequate or excessive correction.
It is advisable to seek a second opinion from another physician to evaluate the patient's condition before proceeding with surgery.

Reply Date: 2005/05/16

More Info

Scoliosis surgery, particularly for adolescents, is a significant decision that requires careful consideration of both the potential benefits and risks involved. Your daughter's condition, with a progression from 38 degrees to 50 degrees, indicates that her scoliosis is worsening, and surgical intervention may be necessary to prevent further complications.

Understanding the Risks of Scoliosis Surgery
1. Surgical Risks: As with any major surgery, scoliosis surgery carries inherent risks. These can include:
- Infection: There is a risk of infection at the surgical site, which can complicate recovery.

- Blood Loss: Significant blood loss can occur during surgery, sometimes requiring transfusions.

- Nerve Damage: There is a risk of nerve injury, which could lead to weakness, numbness, or paralysis in the lower extremities.

- Anesthesia Risks: General anesthesia carries its own risks, particularly for patients with underlying health issues, though these are generally low in healthy adolescents.

- Hardware Complications: The surgical procedure often involves the placement of rods and screws to stabilize the spine. These can sometimes become loose or break, necessitating additional surgeries.

2. Long-term Risks: While the immediate risks are concerning, it's also important to consider long-term implications:
- Chronic Pain: Some patients may experience chronic pain post-surgery, which can affect quality of life.

- Limited Mobility: Depending on the extent of the surgery, there may be limitations in mobility or physical activities post-recovery.

- Psychological Impact: The physical changes and recovery process can also have psychological effects, including anxiety or depression.

Improvement Rates and Outcomes
The primary goal of scoliosis surgery is to halt the progression of the curve and improve spinal alignment. Studies show that surgery can reduce the curvature by an average of 50% to 70%, depending on the severity of the curve and the specific surgical technique used. Many patients report significant improvements in their quality of life, including better posture, reduced pain, and enhanced physical function.

Alternatives to Surgery
Before proceeding with surgery, it's essential to explore all available options:
- Bracing: While your daughter has already undergone bracing, it is worth discussing with her physician whether any adjustments or alternative bracing methods could be beneficial.

- Physical Therapy: Engaging in a tailored physical therapy program can help strengthen the muscles around the spine and improve posture, potentially slowing the progression of scoliosis.

- Observation: In some cases, especially if the curve is not rapidly progressing, doctors may recommend a watchful waiting approach, monitoring the curve over time.

Conclusion and Recommendations
As a parent, your concerns about the potential risks and long-term effects of scoliosis surgery are completely valid. It is crucial to have an open and thorough discussion with your daughter's orthopedic surgeon about the specific risks associated with her case, the expected outcomes, and any alternative treatment options. Consider seeking a second opinion from another specialist, particularly one who has extensive experience in treating adolescent scoliosis.

Ultimately, the decision should be made collaboratively, weighing the potential benefits of surgery against the risks and considering your daughter's overall health, lifestyle, and personal preferences. It may also be beneficial to connect with support groups or other families who have gone through similar experiences to gain insights and emotional support during this challenging time.

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