Scoliosis Correction and Fusion
There are three categories of treatment for scoliosis: observation over time, bracing, and surgery.
Observation and Monitoring
This option is generally recommended for children and adolescents when the curvature is small or moderate (less than 20-25 degrees), and a child is still growing. For adults, observation, exercise and physical therapy are recommended if the curves are not large. This is combined with the judicious use of non-steroidal anti-inflammatory medications. Nerve root blocks or epidural steroid injections may also be used to help alleviate leg pain occurring as a result of a pinched nerve in the lumbar spine (lower back).
When curves are between 25 and 45 degrees, bracing is generally recommended for children to prevent further progression of the curve while the spine is still growing. Although the brace cannot correct curving, the goal is to prevent further progression of the deformity.
Surgery is usually recommended for adolescents and adults when the curvature is greater than 45 degrees. It can also be performed in cases of milder curvature if the scoliosis symptoms cause pain or if the condition poses a health risk. The goal is to straighten and balance the spine and secure it in place through spinal fusion so curve progression stops while skeletal maturity is reached. The surgery does not cure scoliosis; rather it is a way to correct the curve and manage the progression of the disease to avoid greater deformity.
Following surgical treatment, no external bracing or casts are used. The hospital stay is generally between four and seven days. Patients can perform regular daily activities in three to four weeks and, depending on the activities of the patient, full participation is allowed between three and six months after surgery. For adults, the length of recovery following surgery varies, depending on the nature of the deformity, the extent of surgery required, and the age of the patient. Often, adult patients benefit from a brief period of time in an inpatient rehabilitation facility following the initial hospital stay.