Scoliosis Treatment Options: From Bracing to Spinal Fusion Surgery

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• What is Scoliosis?
• Pediatric Scoliosis Treatment
• Adult Degenerative Scoliosis
• Scoliosis Surgery Indications
• Importance of Medical Second Opinion
• Full Transcript

What is Scoliosis?

Dr. Eric Woodard, MD, a leading spine neurosurgeon, provides a fundamental definition of scoliosis. He explains that a healthy spine has natural curves in the sagittal plane but is straight when viewed from the front. Scoliosis is an abnormal, snaking curvature of the spine in the coronal or frontal plane. This condition frequently involves a rotation of the individual vertebrae, which contributes to the visible deformity.

Severe scoliosis can be profoundly debilitating. Dr. Woodard references the classic literary example of The Hunchback of Notre Dame to illustrate its potential impact. High-degree scoliosis can affect movement, posture, and even breathing capacity due to the compression of the chest cavity.

Pediatric Scoliosis Treatment

Pediatric scoliosis presents unique challenges because it occurs during a period of spinal growth. Dr. Eric Woodard, MD, notes that treatment for children and adolescents is a specialized field typically managed by pediatric spine specialists. The chosen treatment method depends heavily on the degree of curvature and its rate of progression.

Conservative management is always the first line of defense. This can include vigilant monitoring with repeated measurements, physiotherapy to strengthen core muscles, and bracing. Dr. Woodard confirms that bracing has validity and usefulness for a limited number of patients. However, children whose curves change significantly and rapidly are more likely to be considered for surgical intervention.

Adult Degenerative Scoliosis

The most common form of scoliosis actually occurs in adults. Dr. Eric Woodard, MD, describes how age-related degenerative changes lead to this condition. As bones soften with age and degenerative arthritis progresses, the lumbar spine can begin to slip and develop a scoliotic curve.

This adult degenerative scoliosis often causes secondary problems. The abnormal curvature can lead to spinal stenosis, a narrowing of the spinal canal that results in nerve pinching. This causes pain, numbness, and weakness in the legs, making treatment necessary to address both the deformity and its neurological consequences.

Scoliosis Surgery Indications

Spinal fusion surgery is a major procedure considered only after conservative therapies have failed. Dr. Eric Woodard, MD, explains that surgery is highly effective but comes with significant considerations. The decision is particularly difficult in pediatric cases, as the procedure can arrest some longitudinal spinal growth.

Surgery is typically reserved for patients whose condition is deteriorating rapidly or who have a severe, debilitating curvature. Potential risks and side effects must be carefully weighed. These include the risk of infection, non-union (where the bones fail to fuse), and the impact on a child's future growth. Dr. Anton Titov, MD, and Dr. Woodard discuss how this makes the surgical decision incredibly complex.

Importance of Medical Second Opinion

Given the complexity of scoliosis treatment, Dr. Eric Woodard, MD, and Dr. Anton Titov, MD, strongly advocate for seeking a medical second opinion. A second opinion provides an unbiased angle on a complex situation, helping patients and families weigh all alternative treatment methods with confidence.

This process confirms whether the decision to proceed with scoliosis surgery is correct and complete. It also helps ensure the selection of the most appropriate type of surgical operation. Dr. Anton Titov, MD, concludes that obtaining a medical second opinion is an essential step for making correct health choices regarding scoliosis care.

Full Transcript

Scoliosis surgery decision is justifiably difficult. Medical second opinion helps to weigh alternative scoliosis treatment methods in an unbiased manner. It provides an additional angle of view on a complex scoliosis situation.

Age-related degenerative changes in the spine often worsen scoliosis. A leading spine surgeon shares his view about scoliosis surgical treatment. When is surgery a reasonable option for scoliosis treatment?

Adult scoliosis correction requires intensive physiotherapy to improve core torso and pelvic muscles. Scoliosis involves rotation of individual vertebrae. Scoliosis surgery decision is difficult to make. That is why medical second opinion is warranted in scoliosis.

Surgical treatment for scoliosis can be effective when done for appropriate indications. Medical second opinion confirms that the decision to proceed with scoliosis surgery is correct and complete. It also helps to choose the right type of surgical operation for scoliosis.

Seek medical second opinion on adult scoliosis and be confident that your treatment is correct. Surgery in adolescents with a growing spine is effective, but some growth can be stunted. Scoliosis surgery decision and medical second opinion help patients and families to make correct health choices.

Spinal deformity and scoliosis are common medical conditions that sometimes require spinal fusion. The definitive patient's resource for scoliosis is expert medical second opinion. You should absolutely get at least one medical second opinion.

Get facts on symptoms and treatment of scoliosis from this video interview. Scoliosis surgery does have side effects and potential risks of infection and non-fusion. Problems after adolescent scoliosis surgery include slowed or stunted growth and infections.

Spinal fusion for the treatment of idiopathic scoliosis remains the last measure after conservative therapy has failed and the patient's condition continues to deteriorate.

Dr. Anton Titov, MD: Another common condition is scoliosis. What is scoliosis?

Dr. Anton Titov, MD: What is the best way to treat scoliosis in children, in adolescents, and in adults?

Dr. Eric Woodard, MD: Scoliosis is an entire field of study. It is extremely complicated. The fundamental definition of scoliosis is this. As you know, the spine has several curves running in what we call a sagittal plane.

The sagittal plane divides, bisecting the body in this fashion. There are normal curves of the cervical spine, thoracic, lumbar and sacral portions of the spine. But in the frontal plane the spine is essentially straight.

When the spine starts to weave, such as a snaking type orientation in the coronal or the frontal plane, this is the definition of scoliosis. Scoliosis also not infrequently involves some rotation of individual vertebrae.

Scoliosis can be quite debilitating if it is high degree scoliosis. Because scoliosis is severely deforming. In literature, The Hunchback of Notre Dame is the classic example of severe scoliosis.

The hunched arch and displaced shoulder in scoliosis of Hunchback of Notre Dame affected his movement and breathing. Scoliosis can be quite devastating in children that develop scoliosis during the period of spinal growth.

The most common form of scoliosis, however, is in adults. It is at the other end of the age range. As adults get older their bones soften. As degenerative arthritis progresses, the lumbar spine starts to slip.

The lumbar spine becomes scoliotic, and it causes spinal stenosis or nerve pinching. The appropriate treatments depend upon the type of scoliosis involved.

In young children or adolescents with scoliosis whose spine is growing, this is an entirely different area of study. Pediatric scoliosis treatment is typically under the purview of pediatric spine specialists.

The degree and the rate of change in scoliosis dictates the method of treatment. Sometimes treatment of scoliosis is as aggressive as surgery, or whether it is as vigilant as repeated measurements and minor bracing and/or exercise in scoliosis.

The bracing has some validity and some usefulness in a limited number of patients. But patients who change significantly and who change rapidly are more typically those that are considered for surgical treatment.

Surgery in kids with a growing spine is quite effective. But unfortunately, surgery in scoliosis tends to arrest some of the longitudinal growth. Spine surgery is not the ideal treatment in children with scoliosis ultimately.

Sometimes scoliosis surgery in children can be avoided; that is preferable.

Dr. Anton Titov, MD: What are treatment methods for scoliosis?

Dr. Anton Titov, MD: When to do surgery?