Scoliosis: Should I (or My Child) Have Surgery
What is a Decision Point?
Scoliosis: Should I (or My Child) Have Surgery?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. Scoliosis: Should I (or My Child) Have Surgery? Get the facts Your options
Key points to remember
FAQs What is scoliosis?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. This problem occurs most often in girls ages 10 to 16. In general, about 1 out of 100 people have some type of spinal curve.1 What kind of surgery can fix a spinal curve?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 small children. 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. How can surgery help?Surgery usually can improve the curve and keep it from getting worse. Surgery may also help decrease pain and allow you to do more of your daily activities. Each person's scoliosis is different. Talk to your doctor about whether surgery can help you. What are the risks of surgery?Risks of surgery to fix a spinal curve include:
Talk to your doctor about your or your child's chances of having problems from surgery. Other problems include lost time at work or school for recovery and the possible need to wear a body cast or brace for a few months after surgery. What are the risks of not having surgery?A severe spinal curve that is getting worse and is not fixed with surgery is likely to get worse. As the spinal curve gets worse, the bones of the spine turn toward the inner part of the curve. If the curve is in the upper part of the spine, the ribs may crowd together on one side of the body and become widely separated on the other side. The curve may force the space between the spinal bones to narrow. The spinal bones may also become thicker on the outer edge of the curve. 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 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. Why might your doctor recommend surgery to fix scoliosis?Your doctor might suggest surgery for you or your child if:
Compare your options Compare
Have surgery Have surgery
Don't have surgery
Don't have surgery
Personal stories Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories about surgery for scoliosisThese 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. Linda, age 40 When my daughter was in the sixth grade, I noticed that her clothes seemed to hang unevenly. 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. Marta, age 42 I have lived with scoliosis for most of my life. The curve in my back has not gotten any worse in the past 25 years, so I guess it won't now. My mother had scoliosis and had a lot of problems with it. So my doctor just keeps an eye out for any changes. Henri, age 44 I was diagnosed with scoliosis when I was 22 years old. I was lucky enough not to have any problems until recently. But my spinal curve has gotten worse, and now, at 28 years old, my doctor said it is likely that my curve will get so bad that it will eventually affect my breathing. I decided to go ahead and have surgery so that I won't have problems as I get older. Sarah, age 28 What matters most to you? 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 have surgery for scoliosis Reasons not to have surgery for scoliosis I want to get rid of my back pain. Exercise and over-the-counter medicine work well to control my pain. More important Equally important More important It bothers me that my curved spine keeps me from doing a lot of the activities I like. I'm still able to do the things I like to do. More important Equally important More important I worry that my child's spine will get worse as he or she grows. I would rather wait and see whether my child's spine gets worse as he or she grows. More important Equally important More important I or my child can take a lot of time off from work or school to recover from the surgery. I or my child can't take a lot of time off right now to recover from the surgery. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now? 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. Having surgery NOT having surgery Leaning toward Undecided Leaning toward What else do you need to make your decision? Check the facts 1.
If you have any amount of spinal curve, should you get surgery?
2.
Can a brace help keep a spinal curve from getting worse in children and adults?
3.
Should you consider surgery if your child's moderate curve is getting worse?
Decide what's next 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? Certainty 1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. 3.
Use the following space to list questions, concerns, and next steps. Your Summary Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Your decisionNext steps Which way you're leaning How sure you are Your comments Your knowledge of the factsKey concepts that you understood Key concepts that may need review Getting ready to actPatient choices Credits and ReferencesCredits
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. Scoliosis: Should I (or My Child) Have Surgery?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
1. Get the factsYour options
Key points to remember
FAQs What is scoliosis?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. This problem occurs most often in girls ages 10 to 16. In general, about 1 out of 100 people have some type of spinal curve.1 What kind of surgery can fix a spinal curve?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 small children. 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. How can surgery help?Surgery usually can improve the curve and keep it from getting worse. Surgery may also help decrease pain and allow you to do more of your daily activities. Each person's scoliosis is different. Talk to your doctor about whether surgery can help you. What are the risks of surgery?Risks of surgery to fix a spinal curve include:
Talk to your doctor about your or your child's chances of having problems from surgery. Other problems include lost time at work or school for recovery and the possible need to wear a body cast or brace for a few months after surgery. What are the risks of not having surgery?A severe spinal curve that is getting worse and is not fixed with surgery is likely to get worse. As the spinal curve gets worse, the bones of the spine turn toward the inner part of the curve. If the curve is in the upper part of the spine, the ribs may crowd together on one side of the body and become widely separated on the other side. The curve may force the space between the spinal bones to narrow. The spinal bones may also become thicker on the outer edge of the curve. 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 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. Why might your doctor recommend surgery to fix scoliosis?Your doctor might suggest surgery for you or your child if:
2. Compare your options
Personal storiesAre you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories about surgery for scoliosisThese 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." — Linda, age 40 "When my daughter was in the sixth grade, I noticed that her clothes seemed to hang unevenly. 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." — Marta, age 42 "I have lived with scoliosis for most of my life. The curve in my back has not gotten any worse in the past 25 years, so I guess it won't now. My mother had scoliosis and had a lot of problems with it. So my doctor just keeps an eye out for any changes." — Henri, age 44 "I was diagnosed with scoliosis when I was 22 years old. I was lucky enough not to have any problems until recently. But my spinal curve has gotten worse, and now, at 28 years old, my doctor said it is likely that my curve will get so bad that it will eventually affect my breathing. I decided to go ahead and have surgery so that I won't have problems as I get older." — Sarah, age 28 3. What matters most to you?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 have surgery for scoliosis Reasons not to have surgery for scoliosis I want to get rid of my back pain. Exercise and over-the-counter medicine work well to control my pain. More important Equally important More important It bothers me that my curved spine keeps me from doing a lot of the activities I like. I'm still able to do the things I like to do. More important Equally important More important I worry that my child's spine will get worse as he or she grows. I would rather wait and see whether my child's spine gets worse as he or she grows. More important Equally important More important I or my child can take a lot of time off from work or school to recover from the surgery. I or my child can't take a lot of time off right now to recover from the surgery. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?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. Having surgery NOT having surgery Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?Check the facts1. If you have any amount of spinal curve, should you get surgery?
You're right. Surgery is recommended only for severe spinal curve. Most spinal curves are not bad enough to need surgery. 2. Can a brace help keep a spinal curve from getting worse in children and adults?
That's right. A brace can keep a spinal curve from getting worse only in children. It does not help adults. 3. Should you consider surgery if your child's moderate curve is getting worse?
That's right. Doctors usually recommend surgery if a moderate spinal curve is getting worse, or for a severe curve. Decide what's next1. 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? Certainty1. How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps. Credits
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version. Last Revised: July 21, 2011 Author: Healthwise Staff Medical Review: John Pope, MD - Pediatrics & Robert B. Keller, MD - Orthopedics eMedicineHealth Medical Reference from Healthwise 
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions. To learn more visit Healthwise.org © 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. |
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