If you do need surgery for scoliosis, this can be done in a number of ways. Your surgeon will discuss what the best option is for you. The surgical options will depend on what your scoliosis looks like and the surgeon’s preference. Surgery to correct the curvature of the spine can be done to the front or back of the spine, or both. The goals of the surgery are to correct some of the curve and to fuse the spine so that the scoliosis cannot get worse. Fusing the spine means making the bones of the spine join together so that there is no more movement between them. This is usually done by putting rods and screws into the bones, to hold them still, while they grow together.

half_pre-post-surgery.jpgIf you have surgery to the front of the spine, this will involve making an incision on the side of the chest and removing part of one rib so the spine can then be operated on. The discs are the soft spaces between the bones of the spine. They allow bending and straightening and help to hold the bones of the spine together. Removing the discs allows the bones at the front of the spine to grow together and become stiff. If the spine is very stiff, sometimes it is necessary to remove the discs to help straighten the spine as well. After the surgery there will be a tube coming out of the chest to help re-expand the lung. This tube normally stays in for four to five days after the surgery. If you do need to have surgery to the front of the spine it is often necessary to have surgery to the back of the spine as well.

Surgery to the back of the spine is done using an incision down the middle of your back. Again, screws and rods are usually used to hold the bones of the spine in a good position while they grow together. This approach does not require reinflation of the lung afterwards.

There are a number of risks involved with any surgery on the spine, and your surgeon will discuss these with you. The most frightening of these, is the risk of damage to the nerves or the spinal cord itself. Thankfully this is rare. Nerve injury occurs in about one in 300 spinal surgeries. When it does happen, however, it can have major effects, so every precaution is taken to avoid damage to the nerves. During the surgery, special tests are done to check that the spinal cord is still functioning normally. If there are any signs that the spinal cord is unhappy, then the operation may need to be modified or postponed. Injury to the spinal cord can occur without these tests showing any problems, but this is quite rare.

After having surgery for scoliosis, patients notice that their posture has changed. Their shoulder heights are more level and they are better balanced. It is not possible to completely reverse the changes that occur in the ribs due to the twisting of the spine. There is always some residual difference between the two sides of the chest, but this is usually improved.

half_theatre2.jpgMost patients stay in hospital for about one week after their final surgery. During this time patients work with the physiotherapists and occupational therapists to start rehabilitation and learn which activities are safe to do, and what needs to be avoided. It is quite normal to have some pain and to feel a bit “off” during this period in hospital. This normally lasts for a few days and then starts to improve. After one to two weeks, most patients are starting to feel much better.

It may be necessary to wear a brace after surgery for scoliosis. Your surgeon will decide if this is necessary. The brace will normally be measured and fitted a few days after surgery, and will be worn for up to six months. This helps restrict movement in the spine while the bones continue to grow together. You will be seen regularly in the outpatients clinic to make sure everything is going well with your recovery. If you notice any problems, it is important to let your surgeon know about them when you come in. Most patients are very happy with the outcome of their scoliosis surgery. If you would like to meet other people who have had surgery and hear their experiences, this can be arranged by your treating team.