Some information from the internet

I like to do research for as long as I can stand it (there is a psychological pain that comes about from reading about or talking about my scoliosis). Here is some stuff I've found today:

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Surgery Choices

The main type of surgery for scoliosis involves attaching rods to the spine and performing a spinal fusion, which is used to stabilize and reduce the size of the curve and stop the curve from getting worse by permanently joining the vertebrae into a solid mass of bone.

Other techniques are sometimes used, including instrumentation without fusion, a technique that attaches devices such as metal rods to the spine to stabilize a spinal curve without actually fusing the spine together. This is only done in very young children when a fusion, which stops the growth of the fused part of the spine, is not desirable. The child usually has to wear a brace full-time after having this surgery.

What To Think About

The timing of surgery for scoliosis in children is controversial. Some experts believe that surgery should be delayed until the child is at least 10 years old and preferably 12 because spinal fusion stops the growth of the fused part of the spine. However, the rest of the spine will continue to grow normally in children who are still growing.

Surgical treatment in children and teens usually requires several days in the hospital and limitations on activity for approximately a year. In adults, the average hospital stay is longer.

Adults who have surgery for scoliosis that results from changes in the spine due to aging (degenerative scoliosis) are more likely than children to have significant complications. Even though surgery usually reduces their pain, other complications may occur, such as pseudoarthrosis and wound infections.

(WebMD-Scoliosis-Surgery)

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Should I have surgery for Scoliosis?

Introduction:

Surgery for scoliosis is only done to correct severe spinal curves. Most cases of scoliosis are not severe and do not require surgery. Consider the following when making your decision on whether you or your child should have surgery for scoliosis:

• If your spinal curve is less than 25 degrees, have it examined by a doctor every 4 to 6 months to see whether the curve is getting worse. Treatment is not necessary.
  (this is the category I fell into when I was in high school)
  
• If your spinal curve is between 25 and 45 degrees, treatment may be necessary and may involve bracing. Bracing is usually effective in preventing a spinal curve from getting worse, but it cannot correct a curve. Bracing will not help an adult's scoliosis. (this is the category I fall now. As I have told people, bracing will no longer help me.)
  
• If your child has a spinal curve greater than 45 degrees, or if you have a spinal curve greater than 50 degrees, and the curve is getting worse, surgery may be considered.

Medical Information:

What is scoliosis?

Scoliosis is a condition in which the spine curves abnormally from side to side, rather than being straight. The spine may also be twisted (rotated). Scoliosis involves spinal curves, greater than 10 degrees, that are usually S-shaped or C-shaped.

Scoliosis occurs most often in girls who are 10 to 16 years old. In the general population, about 1 in 100 people (1%) have some type of scoliosis.¹

See an illustration of scoliosis.

What kind of surgery is done for scoliosis?

The main type of surgery for scoliosis is a spinal fusion. In this procedure, 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 with the spine, fusing it into proper position.

Instrumentation without fusion is a technique in which metal rods are attached to the spine to stabilize a spinal curve without fusing the vertebrae together. This is only done in small children when fusion of the spine, which stops growth in that area of the spine, is not desirable. The child usually has to wear a brace full-time after having this surgery.

What are the risks of surgery for scoliosis?

New problems that could develop from surgery for scoliosis include the following:

• Problems associated with back surgery, such as nerve damage, lung problems, or spinal cord damage.
• In a child, spinal fusion will stop growth in the area of the spine that is fused.
• General complications from surgery, such as blood clots or infection or complications from anesthesia. The risk of these complications is higher in older adults.

Talk to your doctor about your or your child's chances of developing 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 for scoliosis?

A severe spinal curve that is progressing and is not treated with surgery is likely to get worse.

As scoliosis gets worse, the bones of the spine rotate toward the inner part of the curve. If the upper part of the spine is affected (thoracic curve), 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 misshapen ribs may reduce the amount of air the lungs can hold and 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 develops in infants may be worse in the long run than scoliosis that develops later in life. If an infant or young child with a severe spinal curve does not have surgery, it is likely that the spinal curve will get worse. This is because the more growing the skeleton has to do, the worse the curve may become.

How effective is surgery for scoliosis?

Surgery for scoliosis effectively prevents further curvature of the spine and usually can make the curvature less severe. Surgery may also help decrease pain and allow people with scoliosis to do more daily activities than they would otherwise.

Each person who has scoliosis is different. Talk to your doctor about what impact surgery for scoliosis is likely to have on you.

Wise Health Decision:

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about surgery for scoliosis. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

Does scoliosis have a major impact on your life?	Yes	No	Unsure
Do you (or your child) have scoliosis caused by an underlying factor that can be treated?	Yes	No	Unsure
If you (or your child) have a severe spinal curve, do you want to wait to see if it progresses?	Yes	No	Unsure
Do you have a spinal curve greater than 50 degrees that is progressing?	Yes	No	NA*
Does your child have a spinal curve greater than 45 degrees that is progressing?	Yes	No	NA
Do you (or your child) have a spinal curve less than 25 degrees?	Yes	No	NA
Are you comfortable with having surgery?	Yes	No	Unsure
Does your home or work situation allow you to take the time necessary to recover after surgery?	Yes	No	Unsure
Has bracing or another treatment for scoliosis been effective?	Yes	No	NA
Do you (or your child) have severe scoliosis that is irreversible and caused by a disease or an unknown factor?	Yes	No	NA

*NA = Not applicable

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have surgery for scoliosis.

Check the box below that represents your overall impression about your decision.

Leaning toward having surgery

Leaning toward NOT having surgery

Yes

(WebMD-Should I (or my child) have surgery for scoliosis?)

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If I come up with more later, I'll post it.