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.
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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.
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 younger children who are still growing. 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 your child to do more daily activities.
Each child's scoliosis is different. Talk to your child's doctor about whether surgery can help.
Risks of surgery to fix a spinal curve include:
Talk to your doctor about your child's chances of having problems from surgery.
Other problems include lost time at school or at work for recovery and the possible need to wear a body cast or brace for a few months after surgery.
A moderate to severe spinal curve that is getting worse and is not fixed with surgery is likely to keep getting worse.
As scoliosis gets worse, the bones of the spine move toward the inside of the curve. If it happens in the upper part of the spine, the ribs may crowd together on one side and spread apart on the other side. The curve may force the spinal bones closer together. The spinal bones on the outer edge of the curve may also get thick.
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 breathing problems and 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 your child if:
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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.
Mother of Linda, age 17
When my daughter was in the sixth grade, 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.
Father of Marta, age 14
My daughter's doctor says her scoliosis curve is moderate and surgery might keep it from getting worse. But surgery scares me, and the scoliosis isn't bothering her. I'd rather take her to regular checkups for a while and see if the curve gets worse.
Mother of Sarah, age 12
We had a long talk about surgery. My 13-year-old really misses playing sports and wants to be in the best shape possible when older. So it's important to me too. We're choosing surgery.
Parent of Casy, age 13
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 schedule surgery for scoliosis
Reasons not to schedule surgery for scoliosis
I want to get rid of my child's back pain.
Exercise and over-the-counter medicine work well to control my child's pain.
A curved spine keeps my child from doing a lot of the activities they like.
My child is still able to do the things they like to do.
I worry that my child's spine will get worse as they grow.
I would rather wait and see if my child's spine gets worse as they grow.
My child can take a time off from school or work to recover from the surgery.
My child can't take a lot of time off right now to recover from the surgery.
My other important reasons:
My other important reasons:
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.
Surgery
Waiting
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
| Author | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | John Pope MD - Pediatrics |
| Primary Medical Reviewer | Adam Husney MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito MD - Family Medicine |
| Primary Medical Reviewer | Robert B. Keller MD - Orthopedics |
| Primary Medical Reviewer | Lesley Ryan MD - Family Medicine |
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.
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 younger children who are still growing. 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 your child to do more daily activities.
Each child's scoliosis is different. Talk to your child's doctor about whether surgery can help.
Risks of surgery to fix a spinal curve include:
Talk to your doctor about your child's chances of having problems from surgery.
Other problems include lost time at school or at work for recovery and the possible need to wear a body cast or brace for a few months after surgery.
A moderate to severe spinal curve that is getting worse and is not fixed with surgery is likely to keep getting worse.
As scoliosis gets worse, the bones of the spine move toward the inside of the curve. If it happens in the upper part of the spine, the ribs may crowd together on one side and spread apart on the other side. The curve may force the spinal bones closer together. The spinal bones on the outer edge of the curve may also get thick.
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 breathing problems and 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 your child if:
| Schedule surgery | Don't schedule surgery | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
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."
— Mother of Linda, age 17
"When my daughter was in the sixth grade, 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."
— Father of Marta, age 14
"My daughter's doctor says her scoliosis curve is moderate and surgery might keep it from getting worse. But surgery scares me, and the scoliosis isn't bothering her. I'd rather take her to regular checkups for a while and see if the curve gets worse."
— Mother of Sarah, age 12
"We had a long talk about surgery. My 13-year-old really misses playing sports and wants to be in the best shape possible when older. So it's important to me too. We're choosing surgery."
— Parent of Casy, age 13
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 schedule surgery for scoliosis
Reasons not to schedule surgery for scoliosis
I want to get rid of my child's back pain.
Exercise and over-the-counter medicine work well to control my child's pain.
A curved spine keeps my child from doing a lot of the activities they like.
My child is still able to do the things they like to do.
I worry that my child's spine will get worse as they grow.
I would rather wait and see if my child's spine gets worse as they grow.
My child can take a time off from school or work to recover from the surgery.
My child can't take a lot of time off right now to recover from the surgery.
My other important reasons:
My other important reasons:
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.
Surgery
Waiting
1. If your child has any amount of spinal curve, should you schedule surgery?
2. Can a brace help keep a child's spinal curve from getting worse?
3. Should you consider surgery if your child's moderate curve is getting worse?
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?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | John Pope MD - Pediatrics |
| Primary Medical Reviewer | Adam Husney MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito MD - Family Medicine |
| Primary Medical Reviewer | Robert B. Keller MD - Orthopedics |
| Primary Medical Reviewer | Lesley Ryan MD - Family Medicine |
Current as of: July 1, 2021
Author: Healthwise Staff
Medical Review:John Pope MD - Pediatrics & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Robert B. Keller MD - Orthopedics & Lesley Ryan MD - Family Medicine
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