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I have co-coordinated treatment with many orthopedic scoliosis specialists in the past and time and time again I see mothers and daughters get completely rail-roaded into the myth of an immediate medically necessary "need" for scoliosis surgery. Often in conversations that last under a minute before a decision is made and without any independent investigation of less invasive alternatives.....or if the patient would be better off doing nothing at all. After all, the primary indication for scoliosis surgery in adolescent idiopathic scoliosis patients is for cosmetic improvement.

Often after years of observation or failed scoliosis brace treatment attempts, the doctor turns to the mother and says "If you love your daugher you'll schedule her for scoliosis surgery right away"....As if there is some some sort of life threatening emergency. There is no consultation of alternatives, no discussion about the short, intermediate, and long-term risks/benefits of the procedure, and generally no mention that this highly invasive procedure isn't even medically necessary from an organic health point of view.....Adolescent idopathic scoliosis (AIS) isn't going to kill you as an adolescent....period. So what is the rush to surgery?

"The current trend for management of these curves is early surgical intervention, the rationale being the ineffectiveness of bracing in preventing the progression of such a large curve and the difficulty in obtaining satisfactory correction by postponing scoliosis surgery to a later date. On the basis of our results, we propose a conservative line of management for these curves, in contrast with current views, rather than to rush into a major spine surgery, expecting a favorable outcome with a well-supervised bracing program. If the curve progresses, scoliosis surgery can always be considered later, keeping in mind the excellent correction obtained with the pedicle screw systems even for large curves of 70 to 100 degrees."

~ A large adolescent idiopathic scoliosis curve in a skeletally immature patient: is early surgery the correct approach? Overview of available evidence.
Telang SS, Suh SW, Song HR, Vaidya SV. Department of orthopedics, Korea University, Guro Hospital, Guro-Dong, Guro-Gu, Seoul, Korea.
J Spinal Disord Tech. 2006 Oct;19(7):534-40.

Many people have made the arguement that scoliosis surgery as a teenager will halt progression in adulthood....which is simply not accurate..........

"Initial average loss of spinal correction post-surgery is 3.2 degrees in the first year and 6.5 after two years with continued loss of 1.0 degrees per year throughout life."

........Keep in mind that the average adulthood progression is 1-3 degrees per year.

Some say, "What about the use of scoliosis surgery patients to provide a better quality of life for them in adulthood." This would hold significant value if it were true......unfortunately for a large percentage of them it is not........

“40% of operated treated patients with idiopathic scoliosis were legally defined as severely handicapped persons”
~Gotze C, Slomka A, Gotze HG, Potzl W, Liljenqvist U, Steinbeck J. Long-term results of quality of life in patients with idiopathic scoliosis after Harrington instrmentation and their relevance for expert evidence. Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8

Others have made the case for "protecting" the patients lung volume.....again, this is a strawman arguement because the there is virtually no coorelation between Cobb angle and lung volume, which varies greatly from case to case......and is not improved post operatively anyway....

"The correlation between the change in Cobb angle and the thoracic volume change was poor for both groups."

~Scoliosis curve correction, thoracic volume changes, and thoracic diameters in scoliotic patients after anterior and posterior instrumentation. Int Orthop 2001;25(2):66-0

The final position many scoliosis surgery supporters take is impact not surgically treating the adolescent patient would have on them psychologically. Unfortunately, that position/assumption is again false.....

“The psychological health status is significantly impaired.”
~Quality of Life and Back Pain: Outcome 16.7 Years After Harrington Instrumentation
Spine 2002 Jul 1;27 (13) :1456-63 Gotze et al, Dept. of O Surg, Hamm,Germany

Can someone please show me where I'm going wrong here or has the world of scoliosis treatment just become "too quick to cut" in terms of Idiopathic Scoliosis in adolescent patients.

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Before all of you scoliosis brace treatment and spine cor bracefans go jumping down my throat......I realize that this is just one case, but it is a cause for some consideration and concern.

I recently treated a patient in my office who began spine cor bracing when his curvature was 32 degrees and approximately 2 years later the spinal curvature was 62 degrees. They stopped using the brace in mid Oct and I evaluated the patient in mid December (2 months with no scoliosis brace)....the spinal curve now measured 83 degrees. That is a 21 degree increase in the 2 months since he stopped using the brace.

In addition, I had a colleague who is well trained in spine cor check the scoliosis brace and he said it was fitted properly.

I know may orthopedic scoliosis specialist recommend weening a patient out of a rigid brace, but I was under the impression that wasn't necessary with spine cor, because it didn't cause brace dependency. 

However, it obviously does to some capacity.