Scoliosis Surgery Risks May Outweigh Benefits

Neuromuscular Retraining is a Better Alternative with Lifelong Results

Scoliosis surgery is not medically necessary in the vast majority of cases.

Scoliosis is only life threatening if a child younger than five years old has severe spinal deformation. When the lungs are not fully developed, there is a rare possibility that scoliosis could cause the heart to stop (cor pulmonale). Most experts agree that after age five, only a scoliosis curve measuring more than 100 degrees would be dangerous to your child's heart.

Yet, surgery is often prematurely recommended when a teenager's scoliosis curve measures over 40 degrees. It also gets recommended before children are done growing — as young as age 14. Surgery may seem like the only option if a doctor says your child "needs it immediately," and the doctor may say that spinal surgeries are much less invasive than they used to be, but all surgery is invasive — especially if it fuses a majority of the 24 vertebrae.

If you can avoid scoliosis surgery, you should. Here is how.

Non-Surgical Scoliosis Treatment Exists

Part of the dilemma is that non-surgical scoliosis treatment information is not readily available. As a result, you may feel like surgery is a bad idea yet think there are no other options. The ScoliSMART™ doctors want you to know that both children and adults have scoliosis treatment options with much better results than surgery.

Related: Can You Work Together with My Orthopedic Specialist?

We use neuromuscular retraining to treat the entire scoliosis condition, not just the spinal curve. Most cases of scoliosis are idiopathic, meaning they have no known cause. Over 80 percent of children with scoliosis have idiopathic scoliosis that occurs between ages 10 and 18. Some children are born with congenital scoliosis, which develops while they are in the womb. It's often difficult to see at birth and not detected until they are older. A few children develop infantile scoliosis between birth and age three (which may correct itself). Others develop juvenile scoliosis between ages 3 and 10.

It's important to mention that most doctors will use the outdated Cobb angle to measure your child's spinal curve. The Cobb angle is the amount of lateral bending visible on an x-ray. We don't rely on this two-dimensional measurement because a scoliosis curve is three-dimensional. It's a twist and bend that creates torque causing more twisting, bending and buckling of the spine. We call this self-feeding loop a "coil down effect." MRIs, three-dimensional posturography, and surface topography provide much more relevant information about your child's scoliosis.

Exercises Target the Root of Scoliosis

Although we don't know the exact causes of idiopathic scoliosis, research does show that miscommunication between the brain and body causes its progression. The postural control centers in the brain should create automatic responses and send out a signal that the body is not balanced, but they don't.

We use patented scoliosis equipment and exercises to retrain the brain so it tells the body to correct its imbalance. Our treatments also decrease soft tissue resistance to unlock the spine. Your child's brain and body actually learn how to hold the spine straighter. This treatment can reduce a curve, halt scoliosis progression and reduce pain for a child or an adult. It stops the progressive coil down effect. If we start this rehabilitation before your child's curve measures 25 degrees, you'll likely never have to discuss surgery with a doctor. That's our goal.

Studies Show the Many Risks of Scoliosis Surgery

Various studies show that surgery is riddled with complications. These risks seem inordinate since surgery does not cure scoliosis, stop its progression or improve functions of the heart and lungs. The following excerpts from various studies fuel our passion for non-surgical treatment.

• Surgery doesn't improve breathing function.
  "Scoliosis approaches that violate the chest wall demonstrate a significant decline in postoperative pulmonary function." "The effect of surgical approaches on pulmonary function in adolescent idiopathic scoliosis," Journal of Spinal Disorders & Techniques (2009)

• Back pain is not eliminated.
  In a study of 118 patients ages 10-17 who underwent spinal deformity correction a minimum of five years prior, "common symptoms included occasional back pain (90, 76%), limited range of motion (52, 44%), activity limitations (54, 46%), waistline imbalance (41, 35%), rib prominence (28, 24%), wound/scar problems (18, 15%), and shortness of breath (18, 15%). There was a high incidence of occasional back pain and activity complaints after surgery for AIS . . ." "Health-related quality-of-life scores, spine-related symptoms, and reoperations in young adults 7 to 17 years after surgical treatment of adolescent idiopathic scoliosis," American Journal of Orthopedics (2015)

• Your child may look better (discounting the scar down the entire back) but at huge risks.
  "Combined anterior and posterior instrumentation and fusion has double the complication rate of either anterior or posterior instrumentation and fusion alone. Combined anterior and posterior instrumentation and fusion also has a significantly higher rate of neurologic complications than anterior or posterior instrumentation and fusion alone." "Complications in spinal fusion for adolescent idiopathic scoliosis in the new millennium," (2006)
  "In this review of a large multicenter database of surgically treated pediatric scoliosis, neuromuscular scoliosis had the highest morbidity, but relatively high complication rates occurred in all groups." "Complications in the surgical treatment of 19,360 cases of pediatric scoliosis," (2011)

• Quality of life is not improved.
  "Spinal fusion has an isolated negative effect on AIS patients' quality of life . . . The overall positive effect of surgery depends on the individual effects of spinal fusion (slight reduction in quality of life) and deformity reduction (modest improvement in quality of life)." "Dissecting the effects of spinal fusion and deformity magnitude on quality of life in patients with adolescent idiopathic scoliosis," (2009)

• Surgery damages psychological health.
  "The psychological health status is significantly impaired." "Quality of Life and Back Pain: Outcome 16.7 Years after Harrington Instrumentation," (2002)

• Many adults with untreated scoliosis are highly-functioning.
  "For social function, childbearing, and marriage, no apparent disadvantageous effects were reported compared to the healthy population. The conclusion is that most individuals with AIS and moderate curve size around maturity function well and lead an acceptable life in terms of work and family. Some patients with larger curves have pulmonary problems, but not to the extent that this affects the life span. This needs to be taken into account when discussing surgery . . ." "Natural history of adolescent idiopathic scoliosis: a tool for guidance in decision of surgery of curves above 50°," Journal of Children's Orthopaedics (2013)

Additional Risks of Scoliosis Fusion Surgery

During a normal life span, more than 50 percent of spinal fusion patients will suffer from long-term scoliosis surgery complications. These can range from chronic lower back pain to permanent disability.

Surgery risks:

• Implant Failure
• Nerve Damage
• Chronic Pain
• Infection

The History of Scoliosis Surgery Failures

The history of scoliosis surgery is full of failure. The first scoliosis surgery in 1865 — the year the civil war ended — had terrible results and ended in a lawsuit, Guerin vs. Malgaigne.

American doctors first performed scoliosis surgery in 1914. Scoliosis surgery was becoming fairly routine by 1941. The Harrington rod scoliosis surgery, in which a stainless steel rod is implanted along the spinal column, was created in 1953. It is estimated that a million people this type of surgery over the following 40 years.

The Harrington rod surgery has been replaced by other surgeries such the eXtreme Lateral Interbody Fusion (XLIF), which may be done alone or with Posterior Lumbar Interbody Fusion (PLIF). The XLIF is called less invasive because the surgeon makes an incision through the patient's side instead of a long incision down the back. The PLIF adds a bone graft fusion in the spine.

Still, a 2010 study says these surgeries continue to pose significant risks.

Pedicle screw systems, first developed by Cotrel & Dubousset, can correct the rotation of the vertebrae and balance the body. This system of screws is said to withstand wear and tear much better than the old spinal rods. Complications during and after surgery are still a huge threat, though. Serious complications include fluid in or around the lungs, spinal cord injuries and death. Lower limb pain, a wound rupture, or infection and pneumonia are among the minor complications and side effects of scoliosis surgery.

Only Rare, Life-threatening Scoliosis Justifies Surgery

Scoliosis is serious. It affects you or your child both physiologically and psychologically. But it is rarely life-threatening, unlike the surgeries to correct spinal deformity. At the ScoliSMART Clinics^®, we don't offer a cure or a quick fix. But we do offer realistic hope and non-surgical treatment that works. We can stop scoliosis progression, reduce curves and reduce pain. With Early Stage Scoliosis Intervention treatment, your child may never experience an obvious scoliosis curve, scoliosis brace, or scoliosis pain.